Emergency: requires immediate attention
Leptospirosis in Adult
Alerts and Notices
Synopsis
Leptospirosis has protean manifestations. Initial symptoms include the onset of remittent fever, chills or rigors (shaking chills), myalgia, headache, low back pain, and conjunctivitis / uveitis. Some cases may also demonstrate a dry cough, nausea, vomiting, diarrhea, abdominal pain, and a pretibial rash of erythematous papules. The illness may progress to Weil disease, a more severe form, which includes jaundice, kidney and/or liver failure, meningitis, pneumonitis with hemoptysis, acute respiratory distress, hemorrhage, shock, and death. The mortality rate is about 40% for Weil disease and between 1%-5% overall.
Leptospirosis may be difficult to diagnose because its initial symptoms are similar to many other diseases, but early diagnosis is crucial, as successful treatment should be started within the first 4 days of illness.
The incubation period of leptospirosis is usually 10-14 days, although it can range anywhere from 2-30 days. The bacteria are typically found in water, soil, or food contaminated with the urine of wild and domestic animals. It is transmitted by ingestion, inhalation, and direct contact with mucosal surfaces or broken skin. The infection can be transmitted person to person only by direct contact with contaminated urine and body fluids.
There is no vaccine against leptospirosis.
People at risk for leptospirosis include military personnel, veterinarians, dog and other pet owners, slaughterhouse and sewer workers, campers, swimmers, waders, white water rafters, and dairy, cattle, and pig farmers.
Codes
ICD10CM:A27.9 – Leptospirosis, unspecified
SNOMEDCT:
77377001 – Leptospirosis
Look For
Subscription Required
Diagnostic Pearls
Subscription Required
Differential Diagnosis & Pitfalls
- Yellow fever may be differentiated, as it is not found in Asia.
- Malaria
- Dengue
- Blastomycosis
- Glanders
- Legionellosis
- Pneumonic plague
- Psittacosis
- Q fever
- Tularemia
- Influenza
- Human immunodeficiency virus (HIV) seroconversion
Best Tests
Subscription Required
Management Pearls
Subscription Required
Therapy
Subscription Required
References
Subscription Required
Last Reviewed:02/16/2017
Last Updated:10/26/2017
Last Updated:10/26/2017
Emergency: requires immediate attention
Leptospirosis in Adult