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Pathology
Leptospira species.
L. interrogans icterohaemorrhagiae causes most severe disease.
Natural host: rat, dog and farm animals. Incubation 7-14 days.
Aetiology
Contact with water contaminated with rat urine e.g. sewer workers. Leptospires can survive in environment for months.
Signs
Conjunctival suffusion.
Symptoms
Fever, rigors, headache with photophobia, marked myalgia, nausea.
Icteric disease (Weil’s disease): jaundice, renal impairment, haemorrhage, systemic inflammatory response or shock.
Investigations
Bloods: FBC, U&E, LFTs
MSU: Proteinuria and casts.
Serological: ELISA.
Treatment
Mainly supportive.
Prognosis
Very good for patients with mild disease but poor in those with severe disease
Chronic eye infection
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