Leptospirosis

Weil’s
disease
Learning objectives of
Leptospirosis :

1. Identify the Leptospirosis and the kissing dis.

2. Clarify the routs of transmission
3. Discuss the presentation and mention the
differential diagnosis of this febrile illness.
4. Identify the local & systemic complications of
the disease
5. Discuss the investigations
6. Explain the important lines of treatment & prevention
of the disease
 introductio
n
 Zoonotic infection Caused by leptospira
species
 Leptospires can enter through:
1. animal bite or urination ( Rats , Dogs)
2. Prolong immersion in contaminated water.


 Clinical features:

I. P 1-2 weeks
1. Bacteremic leptospirosis : fever,myalgia and
sever headache with photophobia and conjuctivitis
2. Aseptic meningitis
3. Icteric leptospirosis (weil,s disease)
 hemorrhage, (epistaxis , Hematemesis , purpura )
 Uveitis , jaundice and hepatomegally
 renal impairment
 Pericarditis , myocarditis & Vasculitis
4. Pulmonary syndrome : hemoptysis , lung
patchy and respiratory failure (ARDS)
 Diagnosis
1. Leucocytosis, thrombocytopenia
2. Abnormal LFT & prolong prothrombin
time
3. High CPK
4. Definitive D X :
 Blood Culture
 Serological agglutination test (MAT)
 PCR for leptospiral D N A
 Treatmen
t
1. Doxycycline 100 mg for a
week or penicillin, cefriaxone
Mild Jarisch -Herxheimer
reaction may occur
2. Supportive therapy ; fluid ,
blood ,dialysis
3. There is no role for the routine use
of corticosteroids in the
management of leptospirosis.
Relapsing fever
Louse borne& Tick borne
Learning objectives of
Relapsing fever:

1. Identify the Relapsing fever

2. Clarify the routs of transmission
3. Discuss the presentation and mention the
differential diagnosis of this febrile illness.
4. Identify the local & systemic complications of
the disease
5. Discuss the investigations
6. Explain the important lines of treatment & prevention
of the disease
 acute recurrent febrile illnesse caused by
bacteria in the genus Rickettsia and Borrelia .
 Tick-borne relapsing fever- R
 • Louse-borne relapsing fever- B
a vector-borne disease transmitted by bites of lice
or ticks
Symptoms
Onset is 5-15 days after bitten.
1. Sudden fever10 days, than relapse
2. tachycardia.
3. Headache , cough and chills
4. Myalgias, Petechia bleeding
5. Hepato - splenomegaly.
6. CNS: coma, cranial neuropathy as Bell
palsy, hemiplegia, meningitis, and fits
Poor prognostic
signs
include:

1. High bilirubin and jaundice,

2. Unconsciousness
3. Bleeding tendency,
4. prolonged QT interval on
ECG .
  Blood smear stained with
Giemsa or Wright stain.

 Tetracycline or Doxycycline is very effective,


a Jarisch-Herxheimer reaction,
fever,sweat tachycardia with hypotension..
 Mortality rate is ** 1% with treatment
** 30-70% without