Leptospira - Revision history

Aidan: /* Clinical Manifestations */

2025-09-30T18:34:13Z

Clinical Manifestations

← Older revision		Revision as of 18:34, 30 September 2025
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	**Corresponds with the appearance of IgM antibodies		**Corresponds with the appearance of IgM antibodies
	**Spirochete is cleared from blood and CSF but detectable in other organs, including urine		**Spirochete is cleared from blood and CSF but detectable in other organs, including urine
	**May develop [[Causes::jaundice]], [[Causes::acute renal failure]], [[Causes::arrhythmias]], pulmonary symptoms, [[Causes::aseptic meningitis]], [[Causes::non-purulent conjunctival injection]], [[Causes::photophobia]], eye pain, muscle tenderness, [[Causes::adenopathy]], and [[~~Causes::hepaosplenomegaly\|~~Causes::hepatosplenomegaly]]		**May develop [[Causes::jaundice]], [[Causes::acute renal failure]], [[Causes::arrhythmias]], pulmonary symptoms, [[Causes::aseptic meningitis]], [[Causes::non-purulent conjunctival injection]], [[Causes::photophobia]], eye pain, muscle tenderness, [[Causes::adenopathy]], and [[Causes::hepatosplenomegaly]]
	*'''Weil disease''' (liver and renal failure) may develop during or directly following the acute phase		*'''Weil disease''' (liver and renal failure) may develop during or directly following the acute phase
	**Liver injury is predominantly [[jaundice]] with elevated bilirubin and only mild liver enzyme rise		**Liver injury is predominantly [[jaundice]] with elevated bilirubin and only mild liver enzyme rise

Aidan at 17:04, 27 September 2024

2024-09-27T17:04:48Z

← Older revision		Revision as of 17:04, 27 September 2024
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	===Serology===		===Serology===

	*Detects IgM antibodies, which appear around day 5 to 7 and likely last for years to decades<ref>Rees EM, Lau CL, Kama M, Reid S, Lowe R, Kucharski AJ (2022) Estimating the duration of antibody positivity and likely time of ''Leptospira'' infection using data from a cross-sectional serological study in Fiji. ''PLoS Negl Trop Dis'' 16(6): e0010506. doi: [~~https~~:~~//doi.org/10.1371/journal.pntd.0010506 10.1371/journal.pntd.0010506~~]~~</ref>~~		*Detects IgM antibodies, which appear around day 5 to 7 and likely last for years to decades[[CiteRef::grassmann2022es]]
	*IgM ELISA, needs confirmation by MAT (Sn 90%, Sp 90%)		*IgM ELISA, needs confirmation by MAT (Sn 90%, Sp 90%)
	**In Canada, this is done at the NML with a turnaround time of up to 30 days		**In Canada, this is done at the NML with a turnaround time of up to 30 days
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	*Usual treatment is [[Is treated by::penicillin]] G 1.5 MU IV q6h, if severe, or [[Is treated by::doxycycline]] 100 mg po bid, if mild		*Usual treatment is [[Is treated by::penicillin]] G 1.5 MU IV q6h, if severe, or [[Is treated by::doxycycline]] 100 mg po bid, if mild
	**May be able to use [[Is treated by::amoxicillin]], [[Is treated by::ampicillin]], [[Is treated by::ceftriaxone]], or [[Is treated by::azithromycin]] as alternatives		**May be able to use [[Is treated by::amoxicillin]], [[Is treated by::ampicillin]], [[Is treated by::ceftriaxone]], or [[Is treated by::azithromycin]] as alternatives
			***It is also likely that [[ertapenem]], [[cefepime]], and [[norfloxacin]] are also effective[[CiteRef::zhang2014ef]]
	***It is also likely that [[ertapenem]], [[cefepime]], and [[norfloxacin]] are also effective<ref>Zhang W, Zhang N, Wang W, Wang F, Gong Y, Jiang H, Zhang Z, Liu X, Song X, Wang T, Ding Z, Cao Y. Efficacy of cefepime, ertapenem and norfloxacin against leptospirosis and for the clearance of pathogens in a hamster model. Microb Pathog. 2014 Dec;77:78-83. doi: [https://doi.org/10.1016/j.micpath.2014.11.006 10.1016/j.micpath.2014.11.006]. Epub 2014 Nov 7. PMID: [https://pubmed.ncbi.nlm.nih.gov/25450882/ 25450882].</ref>
	**May develop a [[Jarisch-Herxheimer reaction]] during treatment (only with [[β-lactams]])		**May develop a [[Jarisch-Herxheimer reaction]] during treatment (only with [[β-lactams]])
	**Duration is 5 to 7 days (except 3 days for [[azithromycin]])		**Duration is 5 to 7 days (except 3 days for [[azithromycin]])

Aidan: /* Serology */

2023-01-12T16:08:17Z

Serology

← Older revision		Revision as of 16:08, 12 January 2023
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	===Serology===		===Serology===

			*Detects IgM antibodies, which appear around day 5 to 7 and likely last for years to decades<ref>Rees EM, Lau CL, Kama M, Reid S, Lowe R, Kucharski AJ (2022) Estimating the duration of antibody positivity and likely time of ''Leptospira'' infection using data from a cross-sectional serological study in Fiji. ''PLoS Negl Trop Dis'' 16(6): e0010506. doi: [https://doi.org/10.1371/journal.pntd.0010506 10.1371/journal.pntd.0010506]</ref>
	*Detects IgM antibodies, which appear around day 5 to 7
	*IgM ELISA, needs confirmation by MAT (Sn 90%, Sp 90%)		*IgM ELISA, needs confirmation by MAT (Sn 90%, Sp 90%)
	**In Canada, this is done at the NML with a turnaround time of up to 30 days		**In Canada, this is done at the NML with a turnaround time of up to 30 days

Aidan: /* Serology */ added links to NML

2023-01-12T16:05:29Z

Serology: added links to NML

← Older revision		Revision as of 16:05, 12 January 2023
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	*Detects IgM antibodies, which appear around day 5 to 7		*Detects IgM antibodies, which appear around day 5 to 7
		⚫	*IgM ELISA, needs confirmation by MAT (Sn 90%, Sp 90%)
			**In Canada, this is done at the NML with a turnaround time of up to 30 days
			**NML information about [https://cnphi.canada.ca/gts/reference-diagnostic-test/4925?labId=1019 ELISA] and [https://cnphi.canada.ca/gts/reference-diagnostic-test/4927?labId=1019 MAT]
	*Microscopic agglutination test (MAT) for antigen detection (Sn 90%, Sp 90%)		*Microscopic agglutination test (MAT) for antigen detection (Sn 90%, Sp 90%)
	**''Leptospira'' antigens are mixed with serum and monitored for agglutination		**''Leptospira'' antigens are mixed with serum and monitored for agglutination
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	**May cross-react with [[syphilis]], [[relapsing fever]], [[Lyme disease]], [[viral hepatitis]], HIV, [[Legionella]], and autoimmune diseases		**May cross-react with [[syphilis]], [[relapsing fever]], [[Lyme disease]], [[viral hepatitis]], HIV, [[Legionella]], and autoimmune diseases
	**Cross-reacts between different serogroups		**Cross-reacts between different serogroups
⚫	*IgM ELISA, needs confirmation by MAT (Sn 90%, Sp 90%~~) (this is the test in Canada~~)
	*Latex agglutination test, needs confirmation by MAT (Sn 80%, Sp 95%)		*Latex agglutination test, needs confirmation by MAT (Sn 80%, Sp 95%)
	*Lateral flow test, needs confirmation by MAT (Sn 80%, Sp 95%)		*Lateral flow test, needs confirmation by MAT (Sn 80%, Sp 95%)
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	*Unclear sensitivity and specificity, but has the potential to diagnose disease before antibodies develop		*Unclear sensitivity and specificity, but has the potential to diagnose disease before antibodies develop
	*Usually done from blood, but can try in urine as well		*Usually done from blood, but can try in urine as well
			*In Canada, [https://cnphi.canada.ca/gts/reference-diagnostic-test/4923?labId=1019 available through the NML] with a turnaround time of 21 days

	===Faine's Criteria===		===Faine's Criteria===

Aidan: /* Management */

2022-09-14T19:16:00Z

Management

← Older revision		Revision as of 19:16, 14 September 2022
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	*Usual treatment is [[Is treated by::penicillin]] G 1.5 MU IV q6h, if severe, or [[Is treated by::doxycycline]] 100 mg po bid, if mild		*Usual treatment is [[Is treated by::penicillin]] G 1.5 MU IV q6h, if severe, or [[Is treated by::doxycycline]] 100 mg po bid, if mild
	**May be able to use [[Is treated by::amoxicillin]], [[Is treated by::ampicillin]], [[Is treated by::ceftriaxone]], or [[Is treated by::azithromycin]] as alternatives		**May be able to use [[Is treated by::amoxicillin]], [[Is treated by::ampicillin]], [[Is treated by::ceftriaxone]], or [[Is treated by::azithromycin]] as alternatives
			***It is also likely that [[ertapenem]], [[cefepime]], and [[norfloxacin]] are also effective<ref>Zhang W, Zhang N, Wang W, Wang F, Gong Y, Jiang H, Zhang Z, Liu X, Song X, Wang T, Ding Z, Cao Y. Efficacy of cefepime, ertapenem and norfloxacin against leptospirosis and for the clearance of pathogens in a hamster model. Microb Pathog. 2014 Dec;77:78-83. doi: [https://doi.org/10.1016/j.micpath.2014.11.006 10.1016/j.micpath.2014.11.006]. Epub 2014 Nov 7. PMID: [https://pubmed.ncbi.nlm.nih.gov/25450882/ 25450882].</ref>
	**May develop a [[Jarisch-Herxheimer reaction]] during treatment (only with [[β-lactams]])		**May develop a [[Jarisch-Herxheimer reaction]] during treatment (only with [[β-lactams]])
	**Duration is 5 to 7 days (except 3 days for [[azithromycin]])		**Duration is 5 to 7 days (except 3 days for [[azithromycin]])

Aidan: Text replacement - " species}}" to "}}"

2022-02-19T15:05:34Z

Text replacement - " species}}" to "}}"

← Older revision		Revision as of 15:05, 19 February 2022
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	*Can do chemoprophylaxis of high risk occupations with [[doxycycline]] 200 mg PO once weekly		*Can do chemoprophylaxis of high risk occupations with [[doxycycline]] 200 mg PO once weekly

	{{DISPLAYTITLE:''Leptospira'' ~~species~~}}		{{DISPLAYTITLE:''Leptospira''}}
	[[Category:Spirochetes]]		[[Category:Spirochetes]]

Aidan: Aidan moved page Leptospira species to Leptospira without leaving a redirect: Text replacement - " species$" to ""

2022-01-27T01:21:42Z

Aidan moved page Leptospira species to Leptospira without leaving a redirect: Text replacement - " species$" to ""

← Older revision	Revision as of 01:21, 27 January 2022
(No difference)

Aidan: Text replacement - "[[Cellular shape::" to "[[Shape::"

2020-10-08T15:06:48Z

Text replacement - "[[Cellular shape::" to "[[Shape::"

← Older revision		Revision as of 15:06, 8 October 2020
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	===Microbiology===		===Microbiology===

	*Thin, flagellated [[~~Cellular shape~~::spirochete]]		*Thin, flagellated [[Shape::spirochete]]
	*Best viewed with darkfield microscopy		*Best viewed with darkfield microscopy
	*Species and serovars are divided into three broad categories within the genus ''Leptospira''		*Species and serovars are divided into three broad categories within the genus ''Leptospira''

Aidan: /* Pathophysiology */

2020-10-08T13:49:32Z

Pathophysiology

← Older revision		Revision as of 13:49, 8 October 2020
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	*Bacteria enter through cuts and abrasions, mucous membranes, conjunctivae, and inhalation		*Bacteria enter through cuts and abrasions, mucous membranes, conjunctivae, and inhalation
	*After entering, it ~~disseminates~~ ~~hematogenously~~		*After entering, it undergoes widespread hematogenous dissemination
			**Essentially causes a vasculitis
	*Human [[Toll-like receptors\|TLR]] 4 cannot bind leptospiral LPS		*Human [[Toll-like receptors\|TLR]] 4 cannot bind leptospiral LPS
			*Leptospirosis can non-specifically bind and activate T cells in some people
	*Virulence factors		*Virulence factors
	**Sphingomyelinase and hemolysin		**Sphingomyelinase and hemolysin
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	*Usually done from blood, but can try in urine as well		*Usually done from blood, but can try in urine as well

	=== Faine's Criteria ===		===Faine's Criteria===

	* [[Faine's criteria]] use clinical, epidemiological, and laboratory findings to diagnose leptospirosis		*[[Faine's criteria]] use clinical, epidemiological, and laboratory findings to diagnose leptospirosis

	==Management==		==Management==

Aidan at 13:40, 8 October 2020

2020-10-08T13:40:07Z

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