Leptospirosis In Humans - Symptoms, Treatment And Prevention

2024 Author: Josephine Shorter | [email protected]. Last modified: 2024-01-07 17:49

Leptospirosis in humans

What is leptospirosis?

Leptospirosis is an acute zoonotic disease of infectious origin, caused by specific pathogens of leptospira, occurring with toxic damage to internal organs, high fever and jaundice.

Leptospira is considered to be the culprit of leptospirosis. They are spiral gram-negative rod microorganisms from the spirochete group. They are very small and, due to their structure, practically do not linger in the human lymphatic system, quickly spreading into the systemic circulation. Pathogens circulate in natural foci of small rodents. A person does not enter the circle of their natural cycle and infection occurs by chance. This is possible only with direct contact of foci of infection with the skin or mucous membranes of a person.

In practice, two ways of spreading leptospira from rodents to humans have been registered:

1. Through the infected water of standing water bodies. In their coastal areas, there is a concentration of pathogens that can get into the water with the feces of rodents;

2. Through contaminated food. Such cases of leptospirosis have repeatedly occurred when the feces of infected rodents fell on food. A person became infected with their use and direct contact of the mucous membrane and leptospira.

The route of transmission of infection is exclusively contact. Although the disease itself belongs to the group of dangerous infections, an infected person is not dangerous to other people, since it does not release leptospira into the environment.

In the body of a patient with leptospirosis, pathogens from minor skin lesions and microtraumas enter the capillary bed, from where they are spread throughout all tissues of the body. Reproduction of leptospira occurs in parenchymal organs with a rich microcirculation (liver, kidneys, muscles, heart). The main target of pathogens in leptospirosis is the endothelial cells of the capillary network of these organs. In this case, severe microcirculatory disorders occur, which underlies their damage and the clinical picture of leptospirosis. The immune system reacts violently to the introduction of leptospira and in a short time triggers defense mechanisms that are responsible for the destruction of pathogens. This process underlies the severe intoxication and fever in leptospirosis.

Symptoms of leptospirosis

The clinical picture of leptospirosis is sometimes not specific and leaves the disease under the guise of other diseases. It is very important to take into account the anamnestic data. In most cases of leptospirosis, patients had contact with water in stagnant reservoirs or stay in natural conditions.

The symptoms of leptospirosis are as follows:

1. Incubation period. Lasts from one to two weeks after initial contact with the pathogen. At this time, there are no pronounced symptoms;
2. Fever. It occurs with the first release of young leptospira from the affected organs. Each subsequent breeding cycle is accompanied by an increase in temperature. Therefore, leptospirotic fever is intermittent in the form of temperature jumps up to 39-40 ° C;
3. Muscle pain. Intense, more pronounced in those muscle groups that are subject to high loads (calves, thighs);
4. Yellowness of the skin and sclera. Appears in almost all cases of leptospirosis in the early stages of the disease. This feature leads to frequent diagnostic errors when leptospirosis is perceived as hepatitis. Do not forget about the existence of anicteric forms of the disease;
5. Severe intoxication (general weakness, fatigue, lethargy, headaches, tachycardia, rapid breathing);
6. Skin rashes. Presented by hemorrhagic elements and hemorrhages over the entire surface of the skin, sclera and conjunctiva, oropharyngeal mucosa;
7. Kidney damage. It manifests itself in the form of oligo-anuria (a decrease in the amount of daily urine in conditions of sufficient water consumption).

The occurrence of oligoanuria in leptospirosis is a critical symptom of the disease. Its existence for more than 5 days in almost all cases ends in death.

Treatment of leptospirosis in humans

Correct diagnosis of leptospirosis in the early stages of the disease is one of the main criteria for the success of its treatment. It includes:

1. Administration of specific anti-leptospirotic sera (hyperimmune gama globulin). It is desirable that these were donor human preparations, not animal products;
2. Antibacterial therapy. It is carried out with drugs to which Leptospira are most sensitive (augmentin, ceftriaxone, tetracycline, amikacin);
3. Detoxification therapy. Reducing the symptoms of intoxication can be achieved by infusion of colloids and crystalloids, vitamins (ascorbic acid, cocarboxylase, vitamins B2 and B12, vicasol);
4. Fight kidney failure. Requires massive infusion therapy: saline, trisol, Ringer's solution, sodium bicarbonate, rheosorbilact, refortan. High-dose diuretics (lasix, furosemide, trifas), calcium chloride or gluconate, aminophylline are mandatory;
5. The fight against hemorrhagic syndrome and microcirculation disorders - the introduction of contrikal, low doses of glucocorticoid hormones (prednisolone, dexamethasone), ethamsylate and vicasol.

Prevention of leptospirosis

Leptospirosis is a dangerous disease with a high mortality rate, but specific preventive measures have not yet been developed. This is due to the fact that different strains of Leptospira differ in antigenic components. Therefore, it is impossible to create a vaccine that would reliably protect against infection.

You can prevent the disease in this way:

1. Fighting small rodents. Must be carried out in residential buildings and, especially, at catering facilities, grocery stores and shops. Each representative of this series of animals can be a carrier of leptospirosis infection;
2. Exclude or limit as much as possible swimming in stagnant water bodies of natural conditions;
3. Use of protective rubberized suits when contact with infected water is necessary;
4. Emergency antibiotic prophylaxis with doxycycline after possible infection or any manifestations of symptoms of the prodromal period.

Article author: Mochalov Pavel Alexandrovich | d. m. n. therapist

Education: Moscow Medical Institute. IM Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational Diseases", in 1996 "Therapy".