Diferencia entre revisiones de «Leptospirosis»
Sin resumen de edición |
(Added background and treatment options) |
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==Background== | ==Background== | ||
#Human exposure from animal urine, contaminated water/soil, or infected animal tissue. | |||
#Portal from break in skin, mucousa, or conjunctiva | |||
#Average incubation of 10 days | |||
[[File:Conjunctivalsuffusion.jpg|200px|thumb|Conjunctival suffusion]] | [[File:Conjunctivalsuffusion.jpg|200px|thumb|Conjunctival suffusion]] | ||
== | ==Clinical Manifestations== | ||
# fvr, myalgia, ha | # fvr, myalgia, ha (75-100% of pts) | ||
# conjuntival suffusion characteristic but not common | # conjuntival suffusion characteristic but not common | ||
# | # meningitis, uveitis, transminitis, proteinuria, hematuria | ||
# Weil syndrome-severe manifestation with jaundice and renal failure, pulmonary hemorrhage, ARDS, myocarditis, and rhabdomyolysis (52% Mortality) | |||
# | |||
==Laboratory findings== | |||
#Confirm by serology | |||
#Culture | |||
#Hypokalemia/Hyponatremia | |||
#Thrombocytopenia | |||
#Sterile pyuria | |||
#Elevated CK | |||
#CSF with elevated wbcs and protein with normal glucose | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
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==Treatment== | ==Treatment== | ||
# | #Ceftriaxone, cefotaxime, PCN, azithromycin, or doxycycline | ||
#Prefer azithro or doxy if unable to distinguish from rickettsial infection. | |||
#Beware of Jarisch-Herxheimer reaction | |||
==See Also== | ==See Also== | ||
Revisión del 22:45 6 jun 2014
Background
- Human exposure from animal urine, contaminated water/soil, or infected animal tissue.
- Portal from break in skin, mucousa, or conjunctiva
- Average incubation of 10 days
Clinical Manifestations
- fvr, myalgia, ha (75-100% of pts)
- conjuntival suffusion characteristic but not common
- meningitis, uveitis, transminitis, proteinuria, hematuria
- Weil syndrome-severe manifestation with jaundice and renal failure, pulmonary hemorrhage, ARDS, myocarditis, and rhabdomyolysis (52% Mortality)
Laboratory findings
- Confirm by serology
- Culture
- Hypokalemia/Hyponatremia
- Thrombocytopenia
- Sterile pyuria
- Elevated CK
- CSF with elevated wbcs and protein with normal glucose
Differential Diagnosis
Fever in traveler
- Normal causes of acute fever!
- Malaria
- Dengue
- Leptospirosis
- Typhoid fever
- Typhus
- Viral hemorrhagic fevers
- Chikungunya
- Yellow fever
- Rift valley fever
- Q fever
- Amebiasis
- Zika virus
Treatment
- Ceftriaxone, cefotaxime, PCN, azithromycin, or doxycycline
- Prefer azithro or doxy if unable to distinguish from rickettsial infection.
- Beware of Jarisch-Herxheimer reaction