Leptospirosis

 

* Tank: rodents; livestock (cattle); dog.

Disposal -> urine.

* Transmission can be direct rat bite (rare); Leptospira enter the body through wounds and erosions of the skin or mucous membranes, the conjunctiva, inhalation or ingestion of aerosol droplets or contaminated fluids.Occupational hazard (sewer workers …).

* Urinary excretion of leptospires begins on day 12.

Leptospira interrogans, the bacterium that causes leptospirosis

Leptospira interrogans, the bacterium that causes leptospirosis

Transmission can be direct rat bite (rare); leptospires enter the body through wounds and erosions of the skin or mucous membranes

* The sudden onset sit: sepsis, pain syndrome (myalgia), mucocutaneous signs (conjunctival suffusion), meningeal syndrome (fickle).

Bacteremic this phase lasts 3-7 days; inconstant fever outbreak occurs on the 15th day (in the absence of treatment).

* Visceral injuries appear from the 3rd day (precocity of their appearance would be a serious argument.

– Liver disease (70%): flamboyant jaundice; the conjugated bilirubins is high

– Renal disease (50-70%): proteinuria and pyuria; favorable

– Neurological disease: lymphocytic meningitis (50%)

– Hemorrhagic Events: epistaxis, gingival bleeding, hematemesis ….

– Other: lung (30%) with cough, hemoptysis; heart (5%) with myocarditis; eye (5%) with uveitis, chorioretinitis, iridocyclitis.

* NFS: leukocytosis with neutrophilia

* Direct Examination: blood (the first 5 days); LCR (the first 5 days); urine (from 12 days).

Between the 6th and 12th day (dumb phase laboratory).

* Serology: the reference reaction is the microscopic agglutination Martin and Petit MAT (after the 10th-12th day)

* Other (serology): the blade on macro-agglutination using Ag TR (common to several Leptospira); ALISA or methods.

* Treatment: Penicillin G; in case of allergy -> doxycycline. (10j or more duration). Prophylaxis -> vaccination.

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