Leptospirosis
Journal Title: Journal Of Pediatric Critical Care - Year 2017, Vol 4, Issue 3
Abstract
Leptospirosis is a zoonotic infection with ubiquitous distribution caused by spirochete leptospira and humans are incidental hosts. Leptospirosis is mostly reported during rainy season when there is freshwater flooding and water logging with poor sewage drainage. Leptospira are transmitted to humans by exposure to a water environment contaminated by urine of the infected animals. There are two distinct phases of leptospirosis, the initial “septicemic phase” due to leptospira mediated injury is closely followed by “immune phase”. Clinical symptoms include fever, headache, myalgia, vomiting, respiratory symptoms, and thus it is difficult to differentiate from other viral illnesses. Leptospira have a predilection for kidneys and causes acute tubular necrosis and interstitial nephritis. The sever form of Leptospirosis is characterized by hepatic, respiratory and renal dysfunctions, hemorrhagic manifestations, cardiovascular collapse and CNS dysfunction. Microscopic Agglutination Test (MAT) is the gold standard for diagnosis, however ELISA is a pragmatic alternative to MAT for confirming the diagnosis. Majority (90%) of leptospirosis cases are mild and can resolve spontaneously. Early initiation of antimicrobials can lead to faster recovery and may prevent from progression to severe leptospirosis. Penicillin, oral or intravenous, are the first lines of therapy. Supportive care is of utmost importance for management of leptospirosis and associated organ dysfunctions.
Authors and Affiliations
Abhijit Choudhary, Arun Baranwal
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