Leptospira interrogans complex - Clinical Manifestation

Clinical Manifestation of Leptospira interrogans complex

Leptospirosis, caused by Leptospira interrogans complex, occurs as two recognizable clinical syndromes:

1. Anicteric leptospirosis

2. Icteric leptospirosis

The incubation period is from 2-30 days but is usually about 10-14 days. The common symptoms include fever, headache, and myalgia.

Anicteria leptospirosis

Anicteric leptospirosis is a self-limiting illness consisting of a septicemic stage, with a high fever and severe headache that lasts 3-7 days followed by an immune stage. Symptoms during the immune stage are milder than in the septicemic stage. The Hallmark of this stage is aseptic meningitis.

Diagnosis is done by demonstration of specific Leptospira interrogans antibodies in the patient's serum. Jaundice does not develop.

Icteric leptospirosis

Icteric leptospirosis a.k.a. Weil’s disease is a severe disease characterized by the development of jaundice. Symptoms are caused by liver, kidney, or vascular dysfunction with lethal hemorrhage (death in 10% of cases). The disease shows two phases: septicemic and immune:

• In the septicemic or leptospiremia stage (1^st stage) microorganisms are isolated from blood, CSF, and tissue. Non-specific influenza-like illnesses with fever and myalgias occur. This phase lasts for 4-7 days. It is followed by a 1-3 days period of improvement. The patient becomes afebrile and asymptomatic.

• The immune (2^nd stage) starts with the recurrence of fever. As the body gives an immune response to infection Ab may be detected in urine but not from blood or CSF. Organs such as the meninges, liver, kidney, and eye are affected.

Clinical syndromes of Leptospira interrogans includes include Aseptic meningitis, jaundice, renal and pulmonary dysfunction, hepatic necrosis, and hemorrhage diastases.