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CASE STUDY OF LEPTOSPIROSISSynonym:
Weil’s Dse, Mud fever,
Canicola fever 
, Flood fever,Swineherd’s Dse, Japanese Seven Days fever 
Definition & Background:
•
a bacterial zoonotic disease caused by spirochaetes of the genus Leptospira thataffects humans and a wide range of animals, including mammals, birds,amphibians, and reptiles
•
first described by Adolf Weil in 1886 when he reported an “acute
infectious disease
with enlargement of spleen, jaundice and nephritis”
Causative Agent:
•
Leptospira-genus bacteria was isolated in 1907 from post mortem renal tissueslice
•
commonly found: Leptospira pyrogenes, Leptospira manilae, & other species likeL. icterohemorrhagiae, L. canicola, L. batavia, L. Pomona, L. javinica
•
in animals often is subclinical; an infected animal may appear healthy even as itsheds leptospires in its urine; humans are dead-end hosts for the leptospire
Predisposing Factors:
 
•
age: < 15 years of age
•
sex: male
•
season: rainy months
•
geographic: prevalent in slum areas
Source of Infection
Infection comes form contaminated food and water, and infected wild life and domesticanimals especially rodents.1.Rats ( L. leterohemoragiae) are the source of Weil’s disease frequently observedamong miners, sewer, and abattoir workers.2.Dogs (L. canicola) can also be the source of infection among veterinarians, breeders, and owners of dogs.3.Mice (L. grippotyphosa) may alos be a source of infection that attacks farmersand flax workers.4.Rats (L. bataviae) are the source of infection that attacks ricefield workers.
Modes of TransmissionIncubation Period:
•
6 – 15 days/ 2 – 8 weeks
Clinical Manifestations:
1st stage: Septicemic/ Leptospiremic Phase (4 – 7 days)
- onset of high remittent fever, chills, headache, anorexia, nausea & vomiting,abdominal pain, joint pains, muscle pains, myalgia, severe prostration, cough,
respiratorydistress
, bloody sputum.
2nd stage: Immune/ Toxic Phase (4 – 30 days)
- if severe, death may occur between the 9th & 16th day2 types:
•
Anicteric (without jaundice) – return of fever of a lower degree with rash,conjunctival injection, headache, meningeal manifestations like disorientation,convulsions & signs of meningeal irritations (with CSF finding of asepticmeningitis)
•
Icteric (with jaundice) – Weil syndrome; hepatic & renal manifestations:hemorrhage, hepatomegaly, hyperbilirubinemia, oliguria, anuria with progressiverenal failure; shock, coma &
congestive heart failure
in severe cases
3rd stage: Convalescence Phase
- Relapses may occur during 4th or 5th week 
 
Diagnosis:
•
culture: blood (1st week)CSF (5th to 12th day)Urine (after 1st wk til pd of convalescence)
•
agglutination tests ( 2nd or 3rd week)
PATHOPHYSIOLOGYComplications:
•
 pneumonia
•
iridocyclitis, optic neuritis
•
 peripheral neuritis
Prognosis:
•
cause of death: renal & hepatic failure
•
dse usually last 1 – 3 weeks but may be more prolonged; relapse may occur 
Treatment:
•
specific measures: beneficial if done < 4 days of dse
•
Aqueous penicillin G (50,000 units/kg/day in 4-6 divided doses intravenously for 7-10 days
•
Tetracycline (20-40 mg/kg/day in 4 doses); may not be given to children < 8 yearsold
•
general measures
•
symptomatic & supportice care
•
administration of fluid, electrolytes & blood as indicated
•
 peritoneal dialysis (for renal failure)
Nursing Interventions:
•
isolation of patient: urine must be properly disposed
•
health teachings: keep a clean environmentLeptospirosisis a bacterial disease that affects humans and animals. It is caused by bacteria of the genus Leptospira. In humans it causes a wide range of symptoms, andsome infected persons may have no symptoms at all. Symptoms of leptospirosis include
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