Makindo Medical Notes

🔎 Please also see Weil’s Disease – the severe form of leptospirosis associated with jaundice, renal failure, and haemorrhage.

🦠 About

• Leptospirosis is a zoonotic bacterial infection caused by Leptospira species.
• Severe cases can progress to Weil’s disease with jaundice, kidney failure, and bleeding.

🔬 Characteristics

• Gram-negative, thin, coiled spirochetes.
• Non-capsulated, non-spore-forming.
• Characteristic hooked ends 🪝 under microscopy.

🧾 Types (Common Serovars)

• Icterohaemorrhagiae – rats 🐀
• Canicola – dogs 🐕
• Hardjo – cattle 🐄
• Pomona – pigs 🐖

🌍 Source

• Spread via contact with urine of infected animals (esp. rats 🐀).
• High-risk groups: canoeists 🚣‍♂️, farmers 🚜, sewage workers 🚧, and those exposed to contaminated water 💧.

🤒 Clinical Features / Pathogenicity

• Early (mild disease): Fever, headache, myalgia, abdominal pain, vomiting, conjunctival suffusion (red eyes 👀).
• Severe (Weil’s disease): Hepatitis with jaundice, renal failure, aseptic meningitis, haemorrhage.
• Can be biphasic – initial flu-like illness → immune phase with organ involvement.

🧪 Investigations

• Serology (MAT test) – main diagnostic tool, but results take time ⏳.
• Leptospira can sometimes be detected in blood (early) or urine (later phase).
• CSF: aseptic meningitis picture with raised lymphocytes.

💊 Sensitivity

• Typically sensitive to:
  • Penicillin 💉
  • Tetracycline
  • Ceftriaxone
  • Doxycycline 💊

🧬 Resistance

• No major resistance patterns reported for Leptospira.

⚕️ Management

• Supportive care: IV fluids, renal support (dialysis if needed), pain relief, monitoring for multi-organ failure.
• Antibiotics: Early treatment shortens disease course and prevents complications.
• Severe cases require hospital admission and sometimes ICU care.