Related articles: Leptospirosis
Definition
Leptospirosis is an acute infectious disease caused by bacteria (spirochetes) belonging to the genus Leptospira .
The infection develops following direct contact with urine, tissues, soil or stagnant water contaminated by infected domestic or wild animals (especially rats and other rodents); leptospires penetrate the body through abrasions or cuts on exposed skin and mucous membranes (conjunctival, nasal and oral). The risk is therefore greater for those subjects who, for professional reasons, come into contact with contaminated environments, such as farmers, breeders, decontamination workers, freshwater fishermen and exterminators.
The incubation period for leptospirosis is 2 to 20 days.
Most common symptoms and signs *
- Miscarriage
- Anemia
- Asthenia
- Increased transaminases
- Chills
- Cachexia
- Abdominal pain
- Chest pain
- Ocular pain
- Muscle pains
- Bruising
- Gastrointestinal hemorrhage
- Hemoptysis
- Hepatomegaly
- Erythema
- Rash
- Ease of bleeding and bruising
- Temperature
- Fotofobia
- Hydrops Fetal
- Increased blood urea
- Hypotension
- Hypovolemia
- Jaundice
- Lethargy
- Headache
- meningism
- Meningitis
- Eyes reddened
- petechiae
- thrombocytopenia
- pyuria
- Polyuria
- Proteinuria
- Nosebleeds
- Blood in the stool
- Blood in the urine
- Nephritic syndrome
- splenomegaly
- Confusional state
- Cough
- He retched
Further indications
Leptopsires produce vasculitic damage, which is responsible for the main clinical manifestations of the disease.
Leptospirosis often has a biphasic pattern. The first phase, called septicemic, begins suddenly with symptoms such as headache, severe muscle pain, chills, recurrent fever (> 39 ° C), cough and chest pain. From the 3rd to the 4th day ocular manifestations appear, such as conjunctival hyperemia, ocular pain, photophobia and uveitis. Some patients have hemoptysis, splenomegaly and hepatomegaly. The septicemic phase lasts 4-9 days and is followed by a phase of defervescence.
The second phase, called immune, occurs between the 6th and 12th day of illness and coincides with the appearance of antibodies against the infection in the serum. The fever returns; skin rashes, meningitis and signs of hepato-renal impairment may occur.
If leptospirosis is contracted during pregnancy, it can cause an abortion. Rarely, optic neuritis and peripheral neuropathy are also seen among the manifestations of the second phase of the disease. In about 3-4 weeks the symptoms tend to resolve.
A particular and severe form of leptospirosis, called icteric or Weil's syndrome, is manifested by persistent fever, jaundice, anemia, sensory impairment, renal dysfunction (proteinuria, pyuria, hematuria and hyperazotemia) and hemorrhagic manifestations (epistaxis, petechia, purpura, ecchymosis, subarachnoid, adrenal or gastrointestinal bleeding Weil syndrome can cause death from renal failure and haemorrhagic shock.
The diagnosis is based on: serological tests to highlight the presence of specific antibodies, research of the bacterium in the blood, urine or CSF, blood count, clinical chemistry tests and liver function tests. Similar symptoms can be caused by viral meningoencephalitis, influenza and hepatitis.
The treatment of leptospirosiprevites the administration of antibiotics (doxycycline, penicillin or ceftriaxone). In severe cases, supportive treatment is also important, which includes hydration and electrolyte reintegration.
In the prevention of leptospirosis it is essential to use personal protective measures, such as the use of gloves and footwear suitable for work in water, stagnant or near the drains, which may have been contaminated.
