ArtsAutosBooksBusinessEducationEntertainmentFamilyFashionFoodGamesGenderHealthHolidaysHomeHubPagesPersonal FinancePetsPoliticsReligionSportsTechnologyTravel

Leptospirosis: Epidemiology, Pathology, Clinical Manifestations, Diagnosis, Treatment And Prevention

Updated on March 25, 2014

The Eye presentation In leptospirosis

Source

Epidemiology And Pathology Of Leptospirosis

Leptospirae cause serious disease in man in different regions. Among the several serotypes, only Leptospirae icterohaemorrhagiae, L. canicola, L. Pomona, L. hebdomadis and L. autumnalis are harmful to man. Most of the leptospirae are primary parasites of domestic and wild animals by occupational exposure. Though leptospiosis used to be described under different synonyms depending on the organism and the clinical manifestation, it is now clear that considerable overlap occurs among them and therefore they are all described together.

Epidemiology: Leptospirae are eliminated in the urine of their animal hosts, which harbor the organisms in the renal tubules. Man gets infected by coming into contact with the infected urine during occupational or recreational activities. Rats, several varieties of other rodents, dogs, pigs and other animals harbor the organisms. Miners, sewer workers, butchers and veterinary surgeons are exposed to the risk occupationally. Other sources of infection are swimming pools and tanks.

Pathology and pathogenesis: The organisms enter by penetrating the skin and mucous membranes. The disease is characterized by generalized endothelial damage. Major lesions are seen in the liver, Kidneys, brain, meninges, muscles and skin. In the early stages, the direct invasion by the parasites causes the damage, but in the later stages, immunological processes also play a part. In the early phase parasites are seen in tissue and secretions. They disappear in the later phases. At autopsy, the demonstrable lesions include renal tubular necrosis, presence of granular and myoglobin casts in the renal tubules, centriolobular of massive necrosis of liver cells with biliary stasis, and petechial hemorrhages in cardiac and skeletal muscles.

Vasculitis In leptospirosis

Source

Clinical Manafestations And Treatment Of leptospirosis

Average incubation period is 10 days, but this may range from 4 to 21 days. The vast majority of infected persons do not develop the clinical disease, which occurs only in 5 to 10%. Onset is that of a flu-like illness with fever, headache, malaise, prostration and muscle pains, In anicteric cases, these may be the only manifestations.

In those cases that develop the classical diseases, after 4 to 7 days of nonspecific illness, the fever subsides temporarily to recur later. During this second phase, immunologic disturbances predominate. Clinical features include jaundice, renal failure, menigeal irritation, petechail hemorrhages from skin and mucosa and myocarditis in some cases. The deep jaundice is out of proportion to the degree of parenchymal liver cell damage, as assessed by liver enzymes. Liver is enlarged in 25% of cases. Most of the cases show severe and characteristic myalgia, especially of neck and back muscles. Myocarditis may give rise to arrhythmias, cardiomegaly or cardiac failure. Hepatorenal lesions predominate in L. icterohemorragiae infections (Weil’s disease). Pretibila skin lesions are often seen in infection with L. autumnalis (Fort-Bragg fever). Leptospira canicola is noted for production of meningeal irritation and conjunctival congestion (Canicola fever). Prlonged uveitis is seen in some cases. Mortality in leptospirosis ranges from 10 to 15%.

Diagnosis: Clinically, the diagnosis should be suspected when sporadic or small outbreaks of jaundice occur, associated with severe myalgia, hemorrhagic manifestations and neutrophil leucocytosis.

Treatment: Leptospirae are sensitive to penicillin and tetracycline. Benzyl penicillin 2.4 or tetracycline eliminates the organisms from the renal tubules, it is preferred by many. Administration of antibiotics late in the disease is not of much benefit. When hepatic, renal, cardiac or hemorrhagic manifestations predominate, therapy is directed towards them.

Prevention: Leptospirosis can be prevented by avoidance of infection from animal sources, personal hygiene and disinfection of infected water sources.

© 2014 Funom Theophilus Makama

Comments

    0 of 8192 characters used
    Post Comment

    • married2medicine profile imageAUTHOR

      Funom Theophilus Makama 

      4 years ago from Europe

      Thank you a lot Eiddwen.... I appreciate your kind words as always

    • Eiddwen profile image

      Eiddwen 

      4 years ago from Wales

      Heard of this being discussed on the radio ;this hub enlightened me further. You really know your stuff and voting up. Wishing you a great day and lots of love from Wales.

      Eddy.

    working

    This website uses cookies

    As a user in the EEA, your approval is needed on a few things. To provide a better website experience, hubpages.com uses cookies (and other similar technologies) and may collect, process, and share personal data. Please choose which areas of our service you consent to our doing so.

    For more information on managing or withdrawing consents and how we handle data, visit our Privacy Policy at: https://hubpages.com/privacy-policy#gdpr

    Show Details
    Necessary
    HubPages Device IDThis is used to identify particular browsers or devices when the access the service, and is used for security reasons.
    LoginThis is necessary to sign in to the HubPages Service.
    Google RecaptchaThis is used to prevent bots and spam. (Privacy Policy)
    AkismetThis is used to detect comment spam. (Privacy Policy)
    HubPages Google AnalyticsThis is used to provide data on traffic to our website, all personally identifyable data is anonymized. (Privacy Policy)
    HubPages Traffic PixelThis is used to collect data on traffic to articles and other pages on our site. Unless you are signed in to a HubPages account, all personally identifiable information is anonymized.
    Amazon Web ServicesThis is a cloud services platform that we used to host our service. (Privacy Policy)
    CloudflareThis is a cloud CDN service that we use to efficiently deliver files required for our service to operate such as javascript, cascading style sheets, images, and videos. (Privacy Policy)
    Google Hosted LibrariesJavascript software libraries such as jQuery are loaded at endpoints on the googleapis.com or gstatic.com domains, for performance and efficiency reasons. (Privacy Policy)
    Features
    Google Custom SearchThis is feature allows you to search the site. (Privacy Policy)
    Google MapsSome articles have Google Maps embedded in them. (Privacy Policy)
    Google ChartsThis is used to display charts and graphs on articles and the author center. (Privacy Policy)
    Google AdSense Host APIThis service allows you to sign up for or associate a Google AdSense account with HubPages, so that you can earn money from ads on your articles. No data is shared unless you engage with this feature. (Privacy Policy)
    Google YouTubeSome articles have YouTube videos embedded in them. (Privacy Policy)
    VimeoSome articles have Vimeo videos embedded in them. (Privacy Policy)
    PaypalThis is used for a registered author who enrolls in the HubPages Earnings program and requests to be paid via PayPal. No data is shared with Paypal unless you engage with this feature. (Privacy Policy)
    Facebook LoginYou can use this to streamline signing up for, or signing in to your Hubpages account. No data is shared with Facebook unless you engage with this feature. (Privacy Policy)
    MavenThis supports the Maven widget and search functionality. (Privacy Policy)
    Marketing
    Google AdSenseThis is an ad network. (Privacy Policy)
    Google DoubleClickGoogle provides ad serving technology and runs an ad network. (Privacy Policy)
    Index ExchangeThis is an ad network. (Privacy Policy)
    SovrnThis is an ad network. (Privacy Policy)
    Facebook AdsThis is an ad network. (Privacy Policy)
    Amazon Unified Ad MarketplaceThis is an ad network. (Privacy Policy)
    AppNexusThis is an ad network. (Privacy Policy)
    OpenxThis is an ad network. (Privacy Policy)
    Rubicon ProjectThis is an ad network. (Privacy Policy)
    TripleLiftThis is an ad network. (Privacy Policy)
    Say MediaWe partner with Say Media to deliver ad campaigns on our sites. (Privacy Policy)
    Remarketing PixelsWe may use remarketing pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to advertise the HubPages Service to people that have visited our sites.
    Conversion Tracking PixelsWe may use conversion tracking pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to identify when an advertisement has successfully resulted in the desired action, such as signing up for the HubPages Service or publishing an article on the HubPages Service.
    Statistics
    Author Google AnalyticsThis is used to provide traffic data and reports to the authors of articles on the HubPages Service. (Privacy Policy)
    ComscoreComScore is a media measurement and analytics company providing marketing data and analytics to enterprises, media and advertising agencies, and publishers. Non-consent will result in ComScore only processing obfuscated personal data. (Privacy Policy)
    Amazon Tracking PixelSome articles display amazon products as part of the Amazon Affiliate program, this pixel provides traffic statistics for those products (Privacy Policy)