Leptospirosis – symptoms, diagnosis, treatment, complications

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Leptospirosis is caused by Leptospira spirochetes, which produce an ondotoxin that affects the occurrence of fever, vascular damage, circulatory disorders, and changes in the parenchymal organs, nervous system and muscles. The source of infection is the urine of sick animals, and the gates are most often damaged skin or mucosa of the gastrointestinal tract.

A few words about Leptospirosis …

Leptospirosis is an infectious disease caused by Leptospira spirochetes. The disease is transmitted by cattle, horses, pigs, domestic and wild animals, and dogs. Outside the body, Leptospira spirochetes die quickly, are very sensitive to drying out and commonly available disinfectants. In turn, they function very well at low temperatures and during freezing. In stagnant water or moist soil, spirochetes can survive for weeks. The reservoir of the germ is small mammals and rodents, e.g. mice, wild animals, domestic and farm animals, e.g. pigs or cattle.

The source of Leptospirosis infection is the urine of infected animals, and the entry points of infection are most often the conjunctiva, damaged skin and damaged mucosa of the gastrointestinal tract or nose. Leptospirosis multiply most rapidly in the liver, from where it re-enter the bloodstream and cause the symptoms of the disease. It may take up to four weeks for the first symptoms to appear. People at highest risk of infection include:

1. hydrulikow,
2. miners,
3. farmers,
4. veterinarians,
5. workers employed in a sewage treatment plant,
6. people who bathe in contaminated water reservoirs,
7. rowers,
8. canoeists,
9. persons who come into contact with the excretions of sick animals.

One of the most common forms of Leptospirosis in Poland is Weil’s disease, transmitted by rats, and mud fever, the reservoir of which is the field and house mice. After entering the body, the germ enters the blood and then to various organs, mainly the liver. There, it multiplies intensively and then reappears in the bloodstream, causing the disease to suddenly onset.

Symptoms of Leptospirosis

The clinical course of Leptospirosis can be divided into two periods:

1. Initial symptoms related to the appearance of the germ in the blood are similar for all spirochetes, that is:

1. sudden onset
2. high fever,
3. chills,
4. headaches,
5. pain in muscles and joints.

In addition, the patients suffer from herpes labialis, conjunctiva and pharyngeal mucosa congestion, skin erythema or rash of various forms, sometimes generalized hemorrhagic diathesis. Haemodynamic disturbances may also appear. After these initial symptoms, the high temperature usually drops and there is a temporary improvement in health. During this period, the spirochetes disappear from the bloodstream and locate themselves in various organs and tissues, leading to toxic and inflammatory changes.

2. In the second period fever is on the rise again, and due to the variety of secondary locations and organ damage caused by the different types of germ, this period is characterized by a wide variety of symptoms.

Two symptomatic groups were distinguished.

1. The jaundice-free form is mild, where the organ changes are small and mainly affect the liver and the meninges.
2. The jaundice form, characterized by a severe course and a serious prognosis. Inflammatory outbreaks are located not only in the liver, but also in other organs, such as the kidneys, meninges, heart, eyes, and lungs. In addition, bleeding diathesis, circulatory failure, renal failure and death may worsen. Usually, however, the disease ends in recovery.

Leptospirosis – diagnosis and treatment

The diagnosis of the disease is based on a medical interview with the patient, observation of symptoms, and in doubtful cases – serological and bacteriological tests. In patients infected with Leptospirosis, a large number of white and red blood cells, and protein in the urine are seen. In diagnostics, attention should also be paid to the differentiation of leptospirosis from other ailments. Sometimes the symptoms look like a common cold or flu. Final diagnosis is possible after performing serological tests.

Treatment of this ailment depends on the form of the disease. Sometimes the (untreated) disease may take several months to develop before the first symptoms appear. Prompt diagnosis is essential for treatment to be effective. For this reason, people who notice disturbing symptoms should consult a doctor as soon as possible. Therapy of patients should take place only in hospital conditions, especially in infectious diseases wards. The treatment uses antibiotics, e.g. tetracycline, cephalosporins, penicillin or chloramphenicol.

Leptospirosis – complications

The most common complications of Leptospirosis include:

1. pneumonia,
2. myocarditis,
3. skin rash
4. nausea,
5. vomiting,
6. headaches,
7. high temperature,
8. chills,
9. muscle and joint pain,
10. liver and kidney damage (manifested by proteinuria or haematuria),
11. vasculitis (characterized by skin bruising, haemoptysis and nosebleeds),
12. acute respiratory failure.

Can Leptospirosis be prevented?

If you want to avoid the disease, you should:

1. avoid swimming in water bodies contaminated with the urine of sick animals;
2. be careful in contact with water from sewers and sewage,
3. always wear safety shoes and protective clothing (this especially applies to professionals in which they are exposed to infection)