Leptospirosis is known in the literature as Weil's disease. Caused by spirochetes of the genus Leptospira , it poses a real threat to humans. What should we know about the disease?
Leptospira spirochetes are found worldwide, but their virulence is determined by the serotype we are dealing with. Some serotypes cause a range of symptoms in diseases that are difficult to control without antibiotic therapy. The L.interrogans species enter the body through damaged skin or mucous membranes. The incidence of the disease varies in different latitudes. Leptospirosis progresses in two periods - the first, which is directly related to the entry of the bacteria into the body, and the second, when there is a response from the immune system.
Symptoms of the disease
Nearly 90% of people with the disease have a mild, flu-like course of symptoms, including headache, fever, chills and sore throat, sometimes followed by nausea, vomiting and skin lesions in the form of a rash. The symptoms last about a week and then disappear. In some patients, headaches and neck stiffness may occur for 5-7 days, which may be indicative of progressive meningitis.
The exacerbation of the disease that occurs in some patients may be associated with the onset of liver and kidney failure, which can lead to multiple organ failure. In this form, the disease is called Weil syndrome - jaundice, haemorrhages and respiratory failure occur. The patient suffers from severe diarrhoea or constipation, haemoptysis, haematuria or scanty urea. On physical examination, additional symptoms such as an accelerated heart rate, reddening of the conjunctivae, auscultatory changes over the lungs, and acute epigastric pain appear.
photo: panthermedia
Diagnosis of the disease
The diagnosis is made on the basis of a medical history and a series of investigations including: biochemical blood tests (ESR, urea concentration, AspAT and AIAT levels), urine tests (evaluation of the presence of proteins, rollers in the sediment), the appearance of spirochetes on microscopic imaging.
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Treatment options
Treatment is based on compulsory hospitalisation in an observation/infection ward. The patient receives antibiotic therapy - penicillins, tetracyclines, chloramphenicol or cephalosporin. If left untreated, the disease can cause haemorrhagic, neurological and cardiac complications. It should be noted that complications from leptospirosis can be permanent. Patients who have progressed to Weil's disease may develop the so-called Jarisch-Herxheimer reaction, which occurs when toxins begin to be released from the spirochetes killed by antibiotics. Symptoms of the aforementioned reaction include sudden fever, chills, itching, vomiting, and blood counts show an increase in CRP, TNF and interleukin-6 and interleukin-8.
How to avoid contracting the disease
The reservoir of the bacterium that causes leptospirosis is wild and domestic animals, making it difficult to prevent the disease in such a way as to be sure not to become ill. When working with animals or during earthworks, it is a good idea to protect mucous membranes and skin. In cases where leptospirosis has been confirmed - e.g. at our workplace or in the region we are travelling to - your doctor may decide to give you a prophylactic dose of doxycycline, which protects you against the growth of the micro-organism and the disease. It is important to remember that those who travel to regions where there is currently an increased incidence of leptospirosis and those whose work involves daily contact with animals or the ground are particularly at risk of contracting the disease. As with any disease: prompt and accurate diagnosis and implementation of treatment allow rapid recovery.