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LEPTOSPIROSIS

Leptospirosis is an infectious disease caused by a particular type of bacteria called a spirochete. Leptospirosis (also known as Weil's disease, canicola fever, canefield fever, nanukayami fever or 7-day fever) is a bacterial zoonotic disease caused by spirochaetes of the genus Leptospira that affects humans and a wide range of animals, including mammals, birds, amphibians, and reptiles. It was first described by Adolf Weil in 1886 when he reported an "acute infectious disease with enlargement of spleen, jaundice and nephritis". The pathogen, Leptospira-genus bacteria was isolated in 1907 from post mortem renal tissue slice. Leptospirosis can be transmitted by rats as well as by skunks, opossums, raccoons, foxes, and other vermin.

Though being recognised among the world's most common zoonosis, leptospirosis is a relatively rare bacterial infection in humans. The infection is commonly transmitted to humans by allowing fresh water that has been contaminated by animal urine to come in contact with unhealed breaks in the skin, eyes or with the mucous membranes.

Except for tropical areas, leptospirosis cases have a relatively distinct seasonality with most of them occurring August through September (in the Northern Hemisphere).

Leptospirosis is worldwide. However, it is most commonly acquired in the tropics. According to the Center for Disease Control and Prevention, approximately 100 cases of leptospirosis are reported each year in the United States.

SYMPTOMS

Leptospirosis symptoms begin from 2 to 25 days after initial direct exposure to the urine or tissue of an infected animal. This can even occur via contaminated soil or water. Veterinarians and farm workers are at particularly high risk.

Incubation period of 2 to 26 days (average 10 days)

The illness typically progresses through three phases.

The first phase of symptoms includes headaches, muscle aches, eye pain with bright lights, followed by chills and fever. Watering and redness of the eyes occur and symptoms seem to improve by day 5 to 9.

The second phase of illness begins after a few days of feeling pretty well. The initial symptoms recur with fever and aching with stiffness of the neck. Some patients develop serious inflammation of the nerve to the eye, brain, spinal column (meningitis), or other nerves.

The final third phase, from 2 to 4 weeks after the initial infection, features recurrent fever and muscle aching. Less common symptoms relate to disease of the gallbladder, lungs, and heart.Approximately 7 to 40% of patients may have muscle tenderness, an enlarged spleen or liver, enlarged lymph glands, sore throat, muscle rigidity, abnormal lung sounds, or skin rash

Leptospirosis with liver disease is called Weil's syndrome and is characterized by yellowing of the eyes (jaundice) from liver disease. Patients with Weil's syndrome can also develop kidney disease and have more serious involvement of the organs affected.

other symptoms

Less common symptoms include joint aches, bone pain, sore throat, and abdominal pain

Nausea, vomiting, and diarrhea (50% of cases)

Dry cough (25-35% of cases)

Abrupt onset of fever, rigors, myalgias, and headache in 75 to 100% of patients

Signs and tests

White blood cell (WBC) counts are generally less than 10,000.
Urinalysis frequently is abnormal.
Elevated creatine kinase is found in approximately 50% of patients.
About 40% of patients have minimal to moderate elevations of liver enzymes.
Diagnosis is most frequently made by serologic (antibody) testing.
Bacteria is best visualized by dark field microscopy, silver stain, or fluorescent microscopy.
Unlike Treponema pallidum, Leptospira can be grown from blood, urine, and CSF. It is slow growing and the laboratory needs to be notified.
Isolation of the organism from the blood is successful in 50% of cases.
Urine cultures become positive during the second week of the illness and remain so for up to 30 days.

Complications include meningitis, respiratory distress and renal interstitial tubular necrosis, which results in renal failure and often liver failure (this severe form of the disease is known as Weil's disease). Cardiovascular problems are also possible. Approximately 5-50% of severe leptospirosis cases are fatal, however, such cases only constitute about 10% of all registered incidents.

HOMOEOPATHIC TREATMENT

Based on genus epidemicus in case of epidemic