Leptospira

  • leptospira

Leptospira is a genus of slender, spiral-shaped spirochete bacteria with hooked ends. They are weakly Gram-negative and require silver stain techniques for visualization. Pathogenic species cause leptospirosis, a globally distributed zoonosis, especially common in warm, humid climates.

Clinical Features

Leptospirosis typically progresses in two phases:

Initial (leptospiremic) phase:

  • Sudden fever
  • Severe headache
  • Muscle pain (notably in calves and lower back)
  • Nausea, vomiting, diarrhea
  • Dry cough
  • Non-purulent conjunctivitis

Immune phase (more severe):

  • Jaundice
  • Liver and kidney failure (Weil’s disease)
  • Pulmonary hemorrhage
  • Aseptic meningitis
  • Myocarditis

Risk factors: contact with contaminated water/soil (animal urine), exposure during agriculture, recreational water activities, veterinary work, urban rodent exposure.

Diagnosis

Diagnosis includes:

  • Serologic testing (MAT or ELISA)
  • PCR (early-stage detection)
  • Culture (blood, urine)
  • Supportive labs:
    • CBC (leukocytosis, thrombocytopenia)
    • Elevated liver enzymes
    • Elevated creatine kinase
    • Urinalysis (proteinuria, hematuria)

Treatment

Antibiotic therapy:

  • Doxycycline (mild cases)
  • Penicillin G or ampicillin (moderate cases)
  • Ceftriaxone or azithromycin (alternative options)

Severe cases require:

  • Hospitalization
  • ICU care
  • Supportive treatment for kidney, liver, or lung complications

Doxycycline prophylaxis may be considered in high-risk situations.

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