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A.D.A.M. Medical Encyclopedia [Internet]. Atlanta (GA): A.D.A.M.; 2013.

A.D.A.M. Medical Encyclopedia.

Leptospirosis

Weil disease; Icterohemorrhagic fever; Swineherd's disease; Rice-field fever; Cane-cutter fever; Swamp fever; Mud fever; Hemorrhagic jaundice; Stuttgart disease; Canicola fever

Last reviewed: September 3, 2012.

Leptospirosis is a rare and severe infection that occurs when you come in contact with Leptospira bacteria.

Causes, incidence, and risk factors

The Leptospira bacteria can be found in fresh water that has been contaminated by animal urine. The infection occurs in warmer climates.

It is not spread from person to person, except in vary rare cases when it is spread through breast milk or from a mother to her unborn child.

Risk factors include:

  • Occupational exposure -- farmers, ranchers, slaughterhouse workers, trappers, veterinarians, loggers, sewer workers, rice field workers, and military personnel
  • Recreational activities -- fresh water swimming, canoeing, kayaking, and trail biking in warm areas
  • Household exposure -- pet dogs, domesticated livestock, rainwater catchment systems, and infected rodents

Leptospirosis is rare in the continental United States. Hawaii has the highest number of cases in the United States.

Symptoms

Symptoms can take 2 - 26 days (average 10 days) to develop, and may include:

  • Dry cough
  • Fever
  • Headache
  • Muscle pain
  • Nausea, vomiting, and diarrhea
  • Shaking chills

Less common symptoms include:

  • Abdominal pain
  • Abnormal lung sounds
  • Bone pain
  • Enlarged lymph glands
  • Enlarged spleen or liver
  • Joint aches
  • Muscle rigidity
  • Muscle tenderness
  • Skin rash
  • Sore throat

Signs and tests

The blood is tested for antibodies to the bacteria.

Other tests that may be done:

Treatment

Medications to treat leptospirosis include:

Complicated or serious cases may need supportive care or treatment in a hospital intensive care unit (ICU).

Expectations (prognosis)

The outlook is generally good. However, a complicated case can be life-threatening if it is not treated promptly.

Complications

Calling your health care provider

Contact your health care provider if you have any symptoms of, or risk factors for, leptospirosis.

Prevention

Avoid areas of stagnant water, especially in tropical climates. If you are exposed to a high risk area, taking doxycycline or amoxicillin may decrease your risk of developing this disease.

References

  1. Ko AI. Leptospirosis. In Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 331.
  2. Levett PN, Haake DA. Leptospira species (leptospirosis). In:Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2009:chap 240.

Review Date: 9/3/2012.

Reviewed by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.

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Copyright © 2013, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only — they do not constitute endorsementscof those other sites. © 1997–2011 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

Copyright © 2013, A.D.A.M., Inc.

What works?

  • Antibiotics for the treatment of leptospirosis
    Leptospirosis is a common disease both in the developed and developing world. It is caused by a bacteria spread by the urine of animals. People travelling, agricultural field workers, hunters, homeless, and others with close animal contact are groups that, in particular, can get leptospirosis. Like many common infections, most people infected with this disease do not feel sick. When people do feel sick, in some instances up to 1 out of every 10 people have died. Whether or not antibiotics should be used, and if used which antibiotic should be used have been matters for debate for many years. This review identified and assessed seven clinical trials that tested antibiotics in patients sick with leptospirosis. Four of these trials compared intravenous penicillin to a placebo. Three of the trials looked at differences between different antibiotics. All trials had high risk of systematic errors (bias) and of random errors (play of chance). When looked at together, these trials do not answer the basic questions about whether or not antibiotics should be used. Part of the reason for this is that there is a wide range of severity among people ill with the disease. Additional randomised clinical trials are needed. Nonetheless, these trials suggest that antibiotics administered to patients who are sick with leptospirosis may make patients feel better two days earlier than they otherwise would have improved. However, it is also possible that when patients are severely ill, penicillin therapy might increase the risk of death or dialysis in comparison to those who receive no antibiotics. Other antibiotics have not been tested in this way. Despite the lack of evidence, if a clinician chooses to treat leptospirosis with an antibiotic, there does not seem to be any difference between the appropriate use of intravenous penicillin, intravenous cephalosporin, doxycyline, or azithromycin. But, for this they have not been tested to the same extent as intravenous penicillin.
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  • Antibodies.

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