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LEPTOSPIROSIS

LEPTOSPIROSIS. Leptospirosis. A common zoonotic disease Caused by L.interrogans and L.biflexa Rats –common hosts Organism shed in the urine Enters the body-skin/mucous membrane Organs affected-kidney, liver, meninges, brain. Clinical Features. Age group of 10-20 years;males

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LEPTOSPIROSIS

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  1. LEPTOSPIROSIS

  2. Leptospirosis • A common zoonotic disease • Caused by L.interrogans and L.biflexa • Rats –common hosts • Organism shed in the urine • Enters the body-skin/mucous membrane • Organs affected-kidney, liver, meninges, brain

  3. Clinical Features • Age group of 10-20 years;males • Malaise, body pain, non specific features of viral fever initially • Conjunctival suffusion, tendernes in calf and lumbar regions • Headache, chills, anorexia and jaundice • Epigastric pain, tenderness and vomiting

  4. Second stage occurs after a week • Common leptospiral syndrome(CLS):20% • CLS+ bleeding tendency:5% • CLS+ meningitis:5% • CLS+ involvement of liver, kidney, lungs etc:70%

  5. Other Manifestations • Renal failure • Meningeal irritation • Petechial haemorrhages from skin, mucous membrane • Myocarditis • Hyptotension • Multi organ failure

  6. Anicteric Milder form Fever, Myalgia, Headache, Conjunctival suffusion 90% patients present with this form Icteric(Weil’s Syndrome) Severe form Jaundice + involvement of other organs Oliguria, anuria, proteinuria 5-10% have this type 2 types of leptospirosis

  7. Weils Syndrome • Weils syndrome can be defined as severe leptospirosis with jaundice accompanied by azotemia, haemorrhage, anemia, disturbance in consciousness and continued fever • Hepato renal syndrome

  8. Complications • Renal failure • Cardiac failure • Respiratory failure • Severe thrombocytopenia, hemoptysis • CNS involvement • Pericarditis

  9. Differential Diagnosis • DHF • Typhoid fever • Septicemia • Pancreatitis • Viral hepatitis • Falciparum malaria • Fulminant hepatic failure

  10. Lab Diagnosis • IgM specific dot ELISA –sensitive and specific • MAT and slide agglutination test-screening

  11. Elevated WBC count with neutrophilia • Increaed ESR (about 60mm) • Serum Bilirubin-mildy elevatedSGOT/SGPT-mildy elevatedHigh levels of CPK

  12. Treatment • Inj Crystalline Penicilline 20 Lakh units i.v 6th hourly • Maintain adequate fluids and hydration • Doxycycline 100mg BD for 7 days • Children-2 to 4 lakh units/kg of Inj. CP for 7 days

  13. Prevention • Avoid infection from animal sources • Personal hygiene • Disinfection of water sources • Health Education • Vaccination of animals and rodent control

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