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Leptospirosis
Definition
Leptospirosis is a rare, severe, and contagious bacterial infection.
Alternative Names
Weil disease; Icterohemorrhagic fever; Swineherd's disease; Rice-field fever; Cane-cutter fever; Swamp fever; Mud fever; Hemorrhagic jaundice; Stuttgart disease; Canicola fever
Causes, incidence, and risk factors
Leptospirosis is caused by exposure to several types of the Leptospira bacteria, which can be found in fresh water that has been contaminated by animal urine. It occurs in warmer climates.
Risk factors include:
- Occupational exposure -- farmers, ranchers, slaughterhouse workers, trappers, veterinarians, loggers, sewer workers, rice field workers, and military personnel
- Recreational activities -- fresh water swimming, canoeing, kayaking, and trail biking in warm areas
- Household exposure -- pet dogs, domesticated livestock, rainwater catchment systems, and infected rodents
Leptospirosis is rare in the continental United States. Hawaii has the highest number of cases in the United States.
Symptoms
Symptoms can take 2 - 26 days (average 10 days) to develop, and may include:
- Dry cough
- Fever
- Headache
- Muscle pain
- Nausea, vomiting, and diarrhea
- Shaking chills
Less common symptoms include:
- Abdominal pain
- Abnormal lung sounds
- Bone pain
- Conjunctivitis
- Enlarged lymph glands
- Enlarged spleen or liver
- Joint aches
- Muscle rigidity
- Muscle tenderness
- Skin rash
- Sore throat
Signs and tests
The blood is tested for antibodies to the bacteria.
Other tests that may be done:
- Creatine kinase
- Liver enzymes
- Urinalysis
- White blood cell count
Treatment
Medications to treat leptospirosis include:
- Chloramphenicol
- Erythromycin
- Penicillins
- Tetracyclines
Complicated cases will need supportive care.
Expectations (prognosis)
The outlook is generally good. However, a complicated case can be life-threatening if it is not treated promptly.
Complications
- Jarisch-Herxheimer reaction when penicillin is given
- Meningitis
- Severe bleeding
Calling your health care provider
Contact your health care provider if you have any symptoms of, or risk factors for, leptospirosis.
Prevention
Avoid areas of stagnant water, especially in tropical climates. If you are exposed to a high risk area, taking doxycycline may decrease your risk of developing disease.
References
Ko AI. Leptospirosis. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 344.
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
