From the Guidelines
Leptospirosis symptoms typically include fever, headache, muscle aches, chills, vomiting, jaundice, red eyes, abdominal pain, diarrhea, and rash, and can progress to severe cases known as Weil's disease, which can cause yellow skin, kidney failure, bleeding, and meningitis. The disease progresses in two phases:
- the initial acute or septicemic phase lasting about a week with flu-like symptoms,
- followed by the immune phase where symptoms may worsen and include meningitis, liver damage, and kidney failure 1. Early symptoms often resemble the flu, making diagnosis challenging. Symptoms usually appear 5-14 days after exposure to the Leptospira bacteria, which enters through cuts, mucous membranes, or contaminated water. Prompt medical attention is crucial if you've been exposed to potentially contaminated water or animal urine and develop these symptoms. Treatment typically involves antibiotics like doxycycline or penicillin, with early intervention significantly improving outcomes, although a systematic review of antibiotic effectiveness in established leptospirosis showed no benefit for antibiotic treatment based on three trials 1. Severe cases may require hospitalization for intravenous antibiotics and supportive care. It is essential to note that treatment should be initiated upon suspicion given the non-specific nature of initial investigations, and patients presenting with classical symptoms and signs of Weil's disease can become very unwell despite therapy and may require renal or liver support 1.
From the Research
Leptospirosis Symptoms
- The symptoms of leptospirosis can vary from mild, nonspecific illness to severe illness resulting in acute renal failure, hepatic failure, and pulmonary hemorrhage 2.
- The clinical manifestations of the disease can include febrile illness, and it should be included in the broad differential diagnosis of febrile illness 2.
- Leptospirosis is an important cause of morbidity and mortality worldwide, and its symptoms can be significant 3.
Diagnosis and Treatment
- Diagnosis of leptospirosis is dependent on accurate prediction of the time of infection, and culture, polymerase chain reaction, and serology may be used to confirm the diagnosis 2.
- Management of leptospirosis is centered on prompt antibiotic therapy using doxycycline or intravenous penicillin G or intravenous ceftriaxone/cefotaxime 2.
- Antibiotics such as cefotaxime, azithromycin, doxycycline, ceftriaxone, and penicillin can significantly reduce the defervescence time in leptospirosis patients 4.
- The use of antibiotics can also result in common adverse reactions such as Jarisch-Herxheimer reaction, rash, headache, and digestive reactions 4.