LEPTOSPIROSIS

LEPTOSPIROSIS

• Gram -ve organism : leptospira interrogans
• Most widespread zoonosis
• Epidemiology

GROUPS AT RISK

• Agriculture & animal husbandry
• Water-related activities - sports or recreational
• Poor community sanitation and sewerage
• Rodents infestation
• Open wounds and chronic disease

INCUBATION PERIOD

CLINICAL MANIFESTATIONS

• Influenza like illness (ILI)
• Muscle pains - calves, lumbar.
• Splenomegaly, lymphadenopathy
• Tachypnoea

BIPHASIC PHASE

SEPTICEMIC PHASE (1ST WEEK)

• Sudden onset high and remitting fever
• Retro-orbital headache, myalgias
• Maculopapular or purpurin rashes
• Vomiting, prostration
• Defervessence before next phase

IMMUNE PHASE (4 - 30 DAYS)

• Aseptic meningitis/meningoencephalitis
• Weil's syndrome : jaundice, renal failure, myocarditis
• ARDS, pulmonary hemorrhage
• Liver failure

INVESTIGATIONS

• FBC BUSE/Creat LFT
• Blood & urine C+S
• PT PTT INR
• CXR/CSF
• Leptospira serology

RESULTS

• Leukocytosis, thrombocytopenia
• Elevated bilirubin
• Deranged liver enzymes
• Elevated CK
• Positive cultures/ serology

SYSTEMS INVOLVED

ANTIBIOTICS (MILD DISEASE)

• Doxycycline 100 mg BD
• Ampicillin 500mg QID
• Amoxicillin 500mg QID

ANTIBIOTICS (SEVERE DISEASE)

• IV Penicillin G 1.5 MU QID
• IV Ceftriaxone 1g OD

MANAGEMENT

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TYPHOID FEVER

TYPHOID FEVER

• Gram -ve salmonella typhi

CASE DEFINITION

CONTAMINATION & TRANSMISSION

• Natural host & reservoir : humans
• Fecal-oral route