Leptospirosis - clinical picture and diagnosis

The clinical picture

Anyone who suffers from leptospirosis does not necessarily have to get seriously ill. However, the disease usually runs in two phases:

First phase

In the first phase, the pathogens in the blood are detectable and ensure a high fever in the patient. After a temporary fading of the fever in the second phase then again to fever episodes, which are not so high and do not last as long as in the first phase.

Second phase

In the second phase of the disease, the pathogens can have established themselves in a wide variety of organs and cause long-term consequences there. Overall, the symptoms of an incubation period of about 4-19 days can be very different. The World Health Organization (WHO) has divided it into four groups, which is the worldwide standard:

  1. A mild, flu-like form with fever, chills, headache and body aches.
  2. Weil's disease (Morbus Weil), named after the German physician Adolf Weil. This form of leptospirosis shows severe liver and kidney involvement with jaundice, kidney failure, bleeding and myocarditis with cardiac arrhythmias.
  3. Serious meningitis or meningoencephalitis.
  4. Bleeding in the lungs with respiratory failure.

The diagnosis

To safely diagnose leptospirosis, either the pathogens must be directly detected or antibodies against the pathogen in the blood must be detected. Antibody detection is performed with the MAT (microagglutination test) reaction, which is the WHO standard method. The MAT dilutes patient sera and adds live leptospiral strains; in the presence of antibodies then visible clumping of the leptospira, which are assessed microscopically. Further studies are available to differentiate leptospirosis from true flu, virus-related jaundice, malaria, typhoid fever, yellow fever, dengue, or non-bacterial brain inflammation.

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