Leptospirosis

BASIC INFORMATION

DEFINITION

A bacterial disease affecting humans and animals, caused by pathogenic subtypes (serovars) of the aerobic gram-negative filamentous spirochetes, Leptospira interrogans and L. kirschneri

SYNONYMS

Weil's disease, Stuttgart disease, fall fever

EPIDEMIOLOGY

SPECIES, AGE, SEX

GENETICS & BREED PREDISPOSITION: More common in hounds, working dogs, and herding breeds (likely greater exposure risk)

RISK FACTORS

CONTAGION & ZOONOSIS

GEOGRAPHY AND SEASONALITY

CLINICAL PRESENTATION

DISEASE FORMS/SUBTYPES

HISTORY, CHIEF COMPLAINT

PHYSICAL EXAM FINDINGS

ETIOLOGY AND PATHOPHYSIOLOGY

DIAGNOSIS

DIAGNOSTIC OVERVIEW

Unexplained fever or signs of renal and/ or hepatic insufficiency should prompt consideration of leptospirosis. Diagnosis is multimodal: a serum titer alone is rarely sufficient, and a combination of history (exposure, clinical signs), physical examination, routine blood test results, serologic titers, and organism demonstration (via PCR) all contribute to confirming or refuting the clinical diagnosis.

DIFFERENTIAL DIAGNOSIS

INITIAL DATABASE

ADVANCED OR CONFIRMATORY TESTING

TREATMENT

TREATMENT OVERVIEW

Treatment goals are to treat bacteremia/leptospiremia, maintain renal perfusion and urine output to minimize renal injury, eliminate bacteria to prevent disease progression and shedding to environment, and treat associated conditions (renal failure, hepatic insufficiency, DIC, uveitis).

ACUTE GENERAL TREATMENT

CHRONIC TREATMENT

Doxycycline, 5 mg/kg PO q 12 h for 2 weeks to eliminate leptospires from tissues, eliminate renal shedding

RECOMMENDED MONITORING

PROGNOSIS AND OUTCOME

PEARLS & CONSIDERATIONS

COMMENTS

PREVENTION

TECHNICIAN TIPS

CLIENT EDUCATION

SUGGESTED READING

Guerra M: Zoonosis update: leptospirosis. J Am Vet Med Assoc 234 (4):472–478, 2009.

Van de Maele I, Claus A, Haesebrouck F, et al: Leptospirosis in dogs: a review with emphasis on clinical aspects. Vet Rec 163:409–413, 2008.

AUTHOR: MARCELLA D. RIDGWAY

EDITOR: DOUGLASS K. MACINTIRE