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What is leptospirosis?
Leptospirosis is an acute zoonotic disease of infectious origin, caused by specific pathogens leptospira, occurring with toxic damage to internal organs, high fever and jaundice.
Leptospira is considered the culprit of leptospirosis. They are spiral-shaped gram-negative rod-shaped microorganisms from the group of spirochetes. They are very small and, due to their structure, practically do not linger in the human lymphatic system, quickly spreading into the systemic circulation. Pathogens circulate in natural habitats of small rodents. A person is not included in the circle of their natural cycle and infection occurs by chance. This is possible only with direct contact of the foci of infection with the skin or mucous membranes of a person.
In practice, two ways of spreading leptospira from rodents to humans have been registered:
Through the infected water of standing water bodies. In their coastal areas, there is a concentration of pathogens that can get into the water with the feces of rodents;
Through contaminated food. Such cases of leptospirosis have repeatedly occurred when the feces of infected rodents fell on food. A person became infected by their use and direct contact of the mucosa and leptospira.
In the body of a patient with leptospirosis, pathogens from minor skin lesions and microtraumas enter the capillary bed, from where they are distributed throughout all tissues of the body. Reproduction of leptospira occurs in parenchymal organs with rich microcirculation (liver, kidneys, muscles, heart). The main target of pathogens in leptospirosis are endothelial cells of the capillary network of these organs. In this case, severe microcirculatory disorders occur, which underlies their defeat and the clinical picture of leptospirosis. The immune system reacts violently to the introduction of leptospira and in a short time launches protective mechanisms that are responsible for the destruction of pathogens. This process underlies the severe intoxication and fever in leptospirosis.
Symptoms of leptospirosis
The clinical picture of leptospirosis is sometimes not specific and leaves the disease under the guise of other diseases. It is very important to take into account the anamnestic data. In most cases of leptospirosis, patients had contact with water from stagnant reservoirs or exposure to natural conditions.
The symptoms of leptospirosis are:
incubation period. Lasts from one to two weeks after the initial contact with the pathogen. At this time, there are no pronounced symptoms;
Fever. Occurs with the first release of young leptospira from the affected organs. Each subsequent breeding cycle is accompanied by an increase in temperature. Therefore, leptospirosis fever is intermittent in the form of temperature jumps up to 39-40 ° C;
Muscle pain. Intense, more pronounced in those muscle groups that are subject to high loads (calves, thighs);
Jaundice of the skin and sclera. Appears in almost all cases of leptospirosis in the early stages of the disease. This feature leads to frequent diagnostic errors when leptospirosis is perceived as hepatitis. Do not forget about the existence of anicteric forms of the disease;
Severe intoxication manifestations (general weakness, fatigue, lethargy, headaches, tachycardia, rapid breathing);
Skin rashes. Represented by hemorrhagic elements and hemorrhages over the entire surface of the skin, sclera and conjunctiva, oropharyngeal mucosa;
Kidney damage. It manifests itself in the form of oligo-anuria (a decrease in the amount of daily urine in conditions of sufficient water intake).
Treatment of leptospirosis in humans
Correct diagnosis of leptospirosis in the early stages of the disease is one of the main criteria for the success of its treatment. It includes:
The introduction of specific antileptospiral sera (hyperimmune gamma globulin). It is desirable that these be donor human preparations, and not animal products;
Antibacterial therapy. It is carried out with drugs to which leptospires are most sensitive (augmentin, ceftriaxone, tetracycline, amikacin);
Detox therapy. Reducing the symptoms of intoxication can be achieved by infusions of colloids and crystalloids, vitamins (ascorbic acid, cocarboxylase, vitamins B2 and B12, vikasol);
Fight against kidney failure. Requires massive infusion therapy: saline, trisol, Ringer’s solution, sodium bicarbonate, reosorbilact, refortan. Be sure to introduce diuretics in high dosages (lasix, furosemide, tripas), calcium chloride or gluconate, aminofillin;
The fight against hemorrhagic syndrome and microcirculation disorders – the introduction of countercal, low doses of glucocorticoid hormones (prednisolone, dexamethasone), etamsylate and vikasol.
Prevention of leptospirosis
Leptospirosis is a dangerous disease with high mortality, but specific preventive measures have not yet been developed. This is due to the fact that different strains of Leptospira differ in antigenic components. Therefore, it is impossible to create a vaccine that would reliably protect against infection.
You can prevent the disease in this way:
Fight against small rodents. It must be carried out in residential buildings and, especially, in catering facilities, grocery warehouses and shops. Each representative of this series of animals may be a carrier of leptospirosis infection;
Exclude or limit as much as possible swimming in stagnant reservoirs of natural conditions;
Use of protective rubberized suits if contact with infected water is necessary;
Emergency antibiotic prophylaxis with doxycycline after a possible infection or the appearance of any manifestations of the symptoms of the prodromal period.