LEPTOSPIROSIS LEPTOSPIROSIS. Leptospirosis A common zoonotic diseaseA common zoonotic disease Caused...
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Transcript of LEPTOSPIROSIS LEPTOSPIROSIS. Leptospirosis A common zoonotic diseaseA common zoonotic disease Caused...
LEPTOSPIROSISLEPTOSPIROSIS
LeptospirosisLeptospirosis
• A common zoonotic diseaseA common zoonotic disease• Caused by L.interrogans and Caused by L.interrogans and
L.biflexaL.biflexa• Rats –common hostsRats –common hosts• Organism shed in the urineOrganism shed in the urine• Enters the body-skin/mucous Enters the body-skin/mucous
membranemembrane• Organs affected-kidney, liver, Organs affected-kidney, liver,
meninges, brainmeninges, brain
Clinical FeaturesClinical Features Age group of 10-20 years;malesAge group of 10-20 years;males Malaise, body pain, non specific Malaise, body pain, non specific
features of viral fever initiallyfeatures of viral fever initially Conjunctival suffusion, tendernes in Conjunctival suffusion, tendernes in
calf and lumbar regionscalf and lumbar regions Headache, chills, anorexia and Headache, chills, anorexia and
jaundicejaundice Epigastric pain, tenderness and Epigastric pain, tenderness and
vomiting vomiting
Second stage occurs after a weekSecond stage occurs after a week Common leptospiral Common leptospiral
syndrome(CLS):20%syndrome(CLS):20% CLS+ bleeding tendency:5%CLS+ bleeding tendency:5% CLS+ meningitis:5%CLS+ meningitis:5% CLS+ involvement of liver, kidney, CLS+ involvement of liver, kidney,
lungs etc:70%lungs etc:70%
Other ManifestationsOther Manifestations
Renal failureRenal failure Meningeal irritationMeningeal irritation Petechial haemorrhages from skin, Petechial haemorrhages from skin,
mucous membranemucous membrane MyocarditisMyocarditis HyptotensionHyptotension Multi organ failureMulti organ failure
2 types of leptospirosis2 types of leptospirosis
AnictericAnicteric
Milder formMilder form Fever, Myalgia, Fever, Myalgia,
Headache, Headache, Conjunctival suffusionConjunctival suffusion
90% patients present 90% patients present with this formwith this form
Icteric(Weil’s Icteric(Weil’s Syndrome)Syndrome)
Severe formSevere form Jaundice + Jaundice +
involvement of other involvement of other organsorgans
Oliguria, anuria, Oliguria, anuria, proteinuriaproteinuria
5-10% have this type5-10% have this type
Weils SyndromeWeils Syndrome
Weils syndrome can be defined as Weils syndrome can be defined as severe leptospirosis with severe leptospirosis with jaundicejaundice accompanied by accompanied by azotemiaazotemia, , haemorrhagehaemorrhage, , anemiaanemia, , disturbance in disturbance in consciousness consciousness andand continued fever continued fever
Hepato renal syndromeHepato renal syndrome
ComplicationsComplications
Renal failureRenal failure Cardiac failure Cardiac failure Respiratory failureRespiratory failure Severe thrombocytopenia, Severe thrombocytopenia,
hemoptysishemoptysis CNS involvementCNS involvement PericarditisPericarditis
Differential DiagnosisDifferential Diagnosis
DHFDHF Typhoid feverTyphoid fever Septicemia Septicemia Pancreatitis Pancreatitis Viral hepatitisViral hepatitis Falciparum malaria Falciparum malaria Fulminant hepatic failureFulminant hepatic failure
Lab DiagnosisLab Diagnosis
IgM specific dot ELISA –sensitive and IgM specific dot ELISA –sensitive and specificspecific
MAT and slide agglutination test-MAT and slide agglutination test-screeningscreening
Elevated WBC count with Elevated WBC count with neutrophilianeutrophilia
Increaed ESR (about 60mm)Increaed ESR (about 60mm)
Serum Bilirubin-mildy elevatedSerum Bilirubin-mildy elevatedSGOT/SGPT-mildy elevatedSGOT/SGPT-mildy elevatedHigh levels of CPKHigh levels of CPK
TreatmentTreatment
Inj Crystalline Penicilline 20 Lakh Inj Crystalline Penicilline 20 Lakh units i.v 6units i.v 6thth hourly hourly
Maintain adequate fluids and Maintain adequate fluids and hydrationhydration
Doxycycline 100mg BD for 7 daysDoxycycline 100mg BD for 7 days
Children-2 to 4 lakh units/kg of Inj. Children-2 to 4 lakh units/kg of Inj. CP for 7 daysCP for 7 days
PreventionPrevention
Avoid infection from animal sourcesAvoid infection from animal sources Personal hygienePersonal hygiene Disinfection of water sourcesDisinfection of water sources Health EducationHealth Education Vaccination of animals and rodent Vaccination of animals and rodent
controlcontrol