Background
- Also known as Weil’s disease; Uncommon (~1 in 1 million; although most common zoonosis in the world)
- Commonly seen in sewage workers; farmers; vets or abattoir workers
- Caused by the spirochete organism Leptospira interrogans
- Classically spread by rat urine but can be spread via contaminated water/soil from contact from infected animals
Presentation
- Fever
- Flu-like symptoms e.g. myalgia; arthralgia; headache; sore throat; nausea/vomiting
- Renal failure (50%)
- Purpura, petechiae, epistaxis, minor haemoptysis
- Jaundice
- Subconjunctival haemorrhage
- Headache and meningism (meningeal infection)
Investigations
- Generic
- LFT- deranged (increase bilirubin and AST/ALT)
- FBC- thrombocytopenia, leukocytosis, anaemia
- U&E- AKI; raised CK
- Urinalysis- proteinuria
- CXR- patchy alveolar haemorrhage
- Diagnosis
- Serology
Management
- High dose doxycycline or benzylpenicillin (for more severe cases)