JOSALYN C.

CONTILLO
caused by a bacterium
called Leptospira interrogans
infect many species of animals, including rats,
mice, moles, livestock (such as cattle, goats,
sheep, horses, and pigs), wild mammals like
raccoons domestic dogs.
Groups at high risk :exposed
occupationally or recreationally to
contaminated soil, water, or infected
animals, including agricultural
workers, veterinarians, rodent control
workers, laboratory workers
Leptospires enter humans through mucous
membranes (primarily eyes, nose, and
mouth) or abraded skin or by ingestion of
contaminated water. After penetration, they
circulate in the bloodstream to all body
organs, causing endothelial lining damage
of small blood vessels with secondary
ischemic damage to end organs.
1. Direct Detection Method
 a. Culture and isolation
 b. Polymerase Chain Reaction (PCR) has the advantage of early
confirmation of the diagnosis especially during the acute
leptospiremic phase (first week of illness) before the appearance of
antibodies.

2. Indirect Detection Methods

 a. Microagglutination Test (MAT) ‐ a four‐fold rise of the titer from
acute to convalescent sera is confirmatory of the diagnosis. In
endemic areas like the Philippines, a single titer of at least 1:1600 in
symptomatic patients is indicative of leptospirosis.
 b. Specific IgM Rapid Diagnostic Tests like. False negative results can
be a problem if the tests are performed during the early stage of the
illness. A second sample should be obtained for suspected cases
with initial negative or doubtful results.
 Penicillin G (6-8 million units/m2/day divided every 4 hr
 IV for 7 days) is recommended
 Doxycycline 2 mg/kg/day divided in 2 doses with maximum
of 100 mg twice daily ( as an alternative for patients allergic
to penicillin.)
 Azithromycin 10mg/kg,single dose with max dose of 500mg -
shown to be as effective as doxycycline and can be used as an
alternative in patients for whom doxycycline is
contraindicated.
 rodent control measures and avoiding contaminated water
and soil.
 Protective clothing (i.e., boots, gloves, and goggles) should
be worn by persons at risk for occupational exposure.
 Leptospirosis was successfully prevented in American
soldiers stationed in the tropics by administering
prophylactic doxycycline (200 mg PO once a week). This
approach may be similarly effective for travelers to highly
endemic areas for short periods; however, there are no
specific pediatric data to support any prophylaxis regimen.