LEPTOSPIROSIS LEPTOSPIROSIS

Leptospirosis A common zoonotic diseaseA common zoonotic disease Caused by L.interrogans and L.biflexaCaused by L.interrogans and L.biflexa Rats –common hostsRats –common hosts Organism shed in the urineOrganism shed in the urine Enters the body-skin/mucous membraneEnters the body-skin/mucous membrane Organs affected-kidney, liver, meninges, brainOrgans affected-kidney, liver, meninges, brain

Clinical Features  Age group of years;males  Malaise, body pain, non specific features of viral fever initially  Conjunctival suffusion, tendernes in calf and lumbar regions  Headache, chills, anorexia and jaundice  Epigastric pain, tenderness and vomiting

 Second stage occurs after a week  Common leptospiral syndrome(CLS):20%  CLS+ bleeding tendency:5%  CLS+ meningitis:5%  CLS+ involvement of liver, kidney, lungs etc:70%

Other Manifestations Other Manifestations  Renal failure  Meningeal irritation  Petechial haemorrhages from skin, mucous membrane  Myocarditis  Hyptotension  Multi organ failure

2 types of leptospirosis  Anicteric  Milder form  Fever, Myalgia, Headache, Conjunctival suffusion  90% patients present with this form  Icteric(Weil’s Syndrome)  Severe form  Jaundice + involvement of other organs  Oliguria, anuria, proteinuria  5-10% have this type

Weils Syndrome  Weils syndrome can be defined as severe leptospirosis with jaundice accompanied by azotemia, haemorrhage, anemia, disturbance in consciousness and continued fever  Hepato renal syndrome

Complications Complications  Renal failure  Cardiac failure  Respiratory failure  Severe thrombocytopenia, hemoptysis  CNS involvement  Pericarditis

Differential Diagnosis  DHF  Typhoid fever  Septicemia  Pancreatitis  Viral hepatitis  Falciparum malaria  Fulminant hepatic failure

Lab Diagnosis  IgM specific dot ELISA –sensitive and specific  MAT and slide agglutination test- screening

 Elevated WBC count with neutrophilia  Increaed ESR (about 60mm)  Serum Bilirubin-mildy elevated SGOT/SGPT-mildy elevated High levels of CPK

Treatment  Inj Crystalline Penicilline 20 Lakh units i.v 6 th hourly  Maintain adequate fluids and hydration  Doxycycline 100mg BD for 7 days  Children-2 to 4 lakh units/kg of Inj. CP for 7 days

Prevention  Avoid infection from animal sources  Personal hygiene  Disinfection of water sources  Health Education  Vaccination of animals and rodent control