What are the symptoms of Leptospirosis?

From the Guidelines

Leptospirosis symptoms can range from mild flu-like symptoms to severe illness characterized by haemorrhage, jaundice, and hepatorenal failure, with a classic biphasic course of an initial bacteraemic phase and a subsequent immune phase 1. The disease typically presents with symptoms such as fever, myalgia, especially of calves, hepatorenal syndrome, and haemorrhage, with conjunctival suffusion being a suggestive sign 1.

• Key symptoms include:
  • Fever
  • Myalgia
  • Hepatorenal syndrome
  • Haemorrhage
  • Conjunctival suffusion In mild cases, the symptoms may be similar to flu-like symptoms, making diagnosis challenging 1. It is essential to note that severe cases can develop Weil's disease, characterized by jaundice, kidney failure, and bleeding, emphasizing the need for prompt medical attention and early antibiotic treatment to reduce severity and duration.

From the Research

Leptospirosis Symptoms

• The symptoms of leptospirosis can range from mild to severe, and can include fever, jaundice, and acute renal failure 2.
• In severe cases, leptospirosis can cause a triad of symptoms known as Weil's disease, which includes jaundice, impaired renal function, and hemorrhage 3.
• Other symptoms of leptospirosis can include:
  • Acute kidney injury (AKI) with nonoliguric renal failure and hypokalemia 4
  • Pulmonary hemorrhage, pulmonary edema, and acute respiratory distress syndrome (ARDS) 4
  • Alveolar hemorrhage and intra-alveolar hemorrhage, which can lead to acute respiratory failure and death 3, 4
• The severity of leptospirosis symptoms can be correlated with prognostic factors such as indicators of renal failure, pulmonary involvement, and electrolyte imbalances 3.

Clinical Manifestations

• Leptospirosis can present with a variety of clinical manifestations, including:
  • Fever and jaundice 2
  • Acute renal failure and impaired renal function 2, 3
  • Severe pulmonary manifestations, including intra-alveolar hemorrhage and acute respiratory failure 3
• The pathophysiology of leptospirosis involves alterations in tubular function, including decreased expression of proximal sodium and water tubular transporters, and increased expression of the Na-K-2Cl cotransporter NKCC2 4.

Treatment and Management

• Antibiotic treatment is effective in the early and late/severe phases of leptospirosis, and can revert all kidney transporters 4.
• Early and daily hemodialysis, low daily net fluid intake, and lung-protective strategies are recommended for critically ill patients with leptospirosis 4.