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Leptospirosis

Leptospirosis is a topic covered in the 5-Minute Clinical Consult.

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Basics

Description

  • Zoonotic disease caused by Leptospira interrogans, a spirochete bacteria
  • Spread via contact with infected water; outbreaks common during increased rainfall or during floods

Epidemiology

Incidence
  • 100 to 200 annual U.S. cases; 50% in Hawaii
  • Estimated incidence 0.1 to 10/100,000 worldwide
  • Most cases occur in tropical climates; can occur in temperate areas
  • Outbreaks can occur following increased rainfall or during floods.

Etiology and Pathophysiology

  • Caused by L. interrogans, a spirochete harbored in mammals (usually rodents) and shed into water or soil
  • There are over 25 serogroups and 250 serovars; illness severity not linked to type
  • Organism is inoculated through breaks in the skin or contact with mucous membranes.
  • Spirochetes migrate through the lymphatic and vascular system to cause disease.
  • Life cycle is completed when spirochetes infect the kidneys and urinary tract and are excreted into fresh water or soil.
Pregnancy Considerations
  • Disease can be spread transplacentally to cause fetal complications; risk of abortion as high as 50%
  • Leptospira can be transmitted through breast milk (1).

Risk Factors

  • Frequent animal contact (farmers, veterinarians, abattoirs)
  • Fresh water exposure (military personnel, aid workers, adventure racers)
  • Increased rainfall or floods, particularly in tropical environments

General Prevention

  • Avoid contaminated water.
  • Wear protective clothing/gear.
  • Consume clean water.

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Citation

Stephens, Mark B., et al., editors. "Leptospirosis." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2019. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688202/all/Leptospirosis.
Leptospirosis. In: Stephens MB, Golding J, Baldor RA, et al, eds. 5-Minute Clinical Consult. 27th ed. Wolters Kluwer; 2019. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688202/all/Leptospirosis. Accessed April 19, 2019.
Leptospirosis. (2019). In Stephens, M. B., Golding, J., Baldor, R. A., & Domino, F. J. (Eds.), 5-Minute Clinical Consult. Available from https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688202/all/Leptospirosis
Leptospirosis [Internet]. In: Stephens MB, Golding J, Baldor RA, Domino FJ, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2019. [cited 2019 April 19]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688202/all/Leptospirosis.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Leptospirosis ID - 1688202 ED - Stephens,Mark B, ED - Golding,Jeremy, ED - Baldor,Robert A, ED - Domino,Frank J, BT - 5-Minute Clinical Consult, Updating UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/1688202/all/Leptospirosis PB - Wolters Kluwer ET - 27 DB - Medicine Central DP - Unbound Medicine ER -