Leptospirosis

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Author:
japanice27
ID:
306739
Filename:
Leptospirosis
Updated:
2015-08-24 00:48:28
Tags:
leptospirosis
Folders:
cdn
Description:
a review about leptospirosis
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  1. LEPTOSPIROSIS/ WEIL'S DISEASE/ CANICOLA FEVER/ HEMORRHAGIC JAUNDICE/ MUD FEVER/ SWINE HERD DISEASE
    • a zoonotic infectious bacterial disease carried out by animals  (domestic and wild).
    • infected URINE contaminates water or food.
    • ingested or inoculated through the skin.
  2. ETIOLOGIC AGENT:
    • genus LEPTOPSPIRA (leptopira interrogans) 
    • -aquatic organism, found in the river and lake waters, sewage and in the sea.
    • -Weil's disease is caused by the serovar icterohemorrhagiae
  3. IP:
    6-15 days
  4. POC:
    Leptospira is found in the URINE bet 10-20 days after disease onset.
  5. SOURCE OF INFECTION:
    • ☐ contaminated food and water.
    • ☐ infected wildlife and domestic animals (esp rodents).

    • 1. RATS (L. icrteroheamorrhagiae): source of Weil's disease: observed among mine, sewer and abattoir workers.
    • RATS (L. bataviae): attacks ricefield workers.
    • 2. DOGS (L. canicola): veterinarians, breeder of dogs.
    • 3. MICE (L. grippotyphosa): farmers and flax workers.
  6. MOT:
    transmitted through: INGESTION or CONTACT with skin/mucus membrane (eyes, nose and mouth and through break of the skin) of infected urines or carcasses of either wild or domestic animals.

    • LEPTOSPIRA:
    • -enters the blood to cause damage. and thereafter to the kidneys, liver, meninges and conjunctivae.
    • -can be transmitted by SEMEN of an infected animal

    • ☐ occupation at risk: veterinarians, slaughter house workers, farmers and sewer workers.
    • ☐ human-to-human transmission is RARE.
  7. S/SX:
    • ☐ range: asymptomatic to fatal.
    • ☐ three septic stages:
    • 1. SEPTIC STAGE:
    • -febrile for 4-7 days.
    • -sudden onset of remittent fever, chills, headache, anorexia, abdominal pain, and severe prostration (physical and mental exhaustion).
    • -resp distress; fever subsides with lysis. 

    • 2. IMMUNE or TOXIC STAGE:
    • -with or without jaundice.
    • -lasts 4-30 days.
    • (+) iritis, headache, meningeal manifestation (disorientation and convulsion), with CSF finding of aseptic meningitis.
    • (+) oliguria, anuria with progressive renal failure
    • (+) shock, coma, and congestive HF (severe cases); death: may occur bet the 9th and 16th day.

    • 3. CONVALESCENCE:
    • -relapse may occur during the 4th and 5th weeks.
  8. LAB. DX:
    • ↦ BUN and CREA
    • ↦ ELISA
    • ↦ liver fxn test: AST, ALT, GGT
    • ↦ leptospira antigen-antibody test
    • ↦ leptospira antibody test
  9. ORGANS OF THE BODY INVADED BY THE ORGANISM:
    • -LIVER> jaundice
    • -KIDNEYS> renal failure
    • -MUSCLES> pain and edema (sometimes)
    • -EYES> conjunctivitis, orange-colored sclera
  10. COMPLICATION:
    • meningitis
    • resp distress
    • renal interstitial tubular necrosis, resulting in RF (Weil's disease)
    • cardio problem
  11. MANAGEMENT:
    • *suppress causative agent.
    • *fight possible cx.
    • *AETIOTROPIC DRUGS: penicillin, ampicillin, amoxicillin, and doxycycline (prophylaxis: 100m.g p.o q 12 hrs for 1 week).
    • *peritoneal dialysis
    • *give f&e and blood
  12. N/I:
    • -ISOLATE pt: dispose urine properly!
    • -darken pt's room
    • -pruritus: skin care
    • -encourage OFI.
  13. PREVENTION:
    • -sanitation: homes, workplace and farms
    • -proper drainage and control of rodents.
    • -vaccinate animals (cattle, dogs, cats and pigs)
    • -tx infected animals and humans.

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