Leptospirosis

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)