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Leptospirosis

Definition

Leptospirosis is an infection. It occurs when you come in contact with leptospira bacteria.

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

These bacteria can be found in fresh water that has been soiled by animal urine. You may get infected if you come in contact with an infected animal. The infection occurs in warmer climates. Leptospirosis is not spread from person to person, except in very rare cases.

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

Weil disease is rare in the continental United States. Hawaii has the highest number of cases in the United States.

Symptoms

Symptoms can take 2 to 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

Exams and Tests

The blood is tested for antibodies to the bacteria.

Other tests that may be done:

Treatment

Medicines to treat leptospirosis include:

  • Ampicillin
  • Azithromycin
  • Ceftriaxone
  •  Cefotaxime 
  • Doxycycline
  • Penicillin

Complicated or serious cases may need supportive care. You may need treatment in a hospital intensive care unit (ICU).

Outlook (Prognosis)

The outlook is generally good. However, a complicated case can be fatal if it is not treated promptly.

Possible Complications

Complications may include:

  • Jarisch-Herxheimer reaction when penicillin is given
  • Meningitis
  • Severe bleeding

When to Contact a Medical Professional

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 take precaution to avoid infection. You can take doxycycline or amoxicillin to decrease the risk.

References

Haake DA, Levett PN. Leptospira species (leptospirosis). In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, Updated Edition. 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 241.

Muehlenbachs A, Zaki SR. Leptospirosis. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 323.

Review Date:8/22/2016
Reviewed By:Laura J. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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