Leptospirosis Definition, Reason, Symptoms, Treatment & Prevention
Understanding
Leptospirosis is a disease caused by Leptospira bacteria. This bacterium spreads through exposure to urine or animals infected with Leptospira.
Not only attacking humans, this bacterium can also infect animals (zoonosis). Leptospira bacteria can live and reproduce in the body of animals for a long time.
Some animals that can be a source of spreading leptospirosis are rats, dogs, cows, pigs, cats, horses, and also wild animals.
Cases of this disease often occur during the rainy season, especially in flood-affected areas with poor sanitation.
Leptospirosis has symptoms similar to influenza. If not treated immediately, this condition can cause damage to internal organs and even be fatal.
Leptospirosis
| Medical specialist | Internal medicine specialist |
| Symptoms | Fever, muscle aches, headache, cough, nausea, vomiting |
| risk factor | Living in flood-prone areas, veterinarians, breeders, camping activities near rivers, swimming in rivers |
| diagnosis | Medical interview, physical examination, supporting examination (blood test, urine test, ELISA, MAT) |
| Treatment | Drugs |
| Drug | Antibiotik (doxycycline, azithromycin, ciprofloxacin), Antietam (ibuprofen, paracetamol) |
| Complications | Renal failure, DIC, heart failure, sepsis, death |
| When to See a Doctor? | If you experience symptoms of leptospirosis and are included in a risk group |
Symptoms
In fact, not all people infected with leptospirosis immediately show complaints.
In general, symptoms only appear after the patient has passed the incubation period, which ranges from 2-30 days (average 5-14 days).
The following symptoms of leptospirosis can appear, namely:
- High fever to chills
- Muscle pain, especially in the calf area
- Headache
- Sore throat
- Dry cough
- Nausea and vomiting
- Red eye
- Diarrhea
- Red spots on the skin
Based on the course of the disease, leptospirosis is divided into two phases, namely the acute phase which generally lasts 5-7 days; This is followed by a period of improvement.
At that stage, the body temperature begins to decrease and the symptoms decrease or even disappear.
However, in the next phase, leptospirosis can become a more severe disease.
The condition of severe leptospirosis is known as Weil‘s disease which is characterized by:
- Fever
- Jaundice (yellow body and eyes)
- Kidney disorders characterized by difficulty urinating
- Bleeding such as nosebleeds, coughing up blood
- Chest pain
- Hard to breathe
- Neck stiffness
Reason
Leptospirosis is caused by infection with Leptospira bacteria that live in the kidneys of animals. The bacteria is excreted in the urine of infected animals and can contaminate soil and water.
Leptospirosis in humans can occur if:
- Drinking water contaminated with Leptospira bacteria
- Entering into water or direct contact with soil contaminated with Leptospira bacteria when there is a wound on the skin
- Eyes, nose and mouth contaminated with water or soil containing Leptospira bacteria
- Consuming food or drink that has been contaminated with Leptospirosis bacteria
Risk Factors
Leptospirosis is often found in tropical and subtropical countries, including Indonesia. Hot and humid air temperatures allow the Leptospira bacteria to survive for a longer period of time.
In addition, there are several risk factors that cause a person to be infected with leptospirosis, including:
- Live in an area prone to flooding
- Having jobs related to water, for example, cleaning ditches, rivers, mining workers, and so on
- Interact with animals, for example, animal owners, breeders, veterinarians, butchers
- Military personnel
- Frequent outdoor activities, such as swimming and camping near lakes or rivers
Diagnosis
Often the symptoms of leptospirosis resemble other diseases such as dengue fever, typhoid fever, or influenza.
Therefore, to make a diagnosis, a specialist in internal medicine will carry out a detailed examination.
The doctor will conduct a medical interview, such as when did the complaint appear; as well as whether there are risk factors for sufferers, such as living in flooded areas, contact with animals, history of travel or outdoor activities.
After that, the doctor will proceed with a physical examination. Examination at this stage can vary based on the severity of the leptospirosis infection experienced.
In the early stages, found increased body temperature, tachycardia (increased heart rate), and red spots on the skin.
In advanced and severe stages, hypotension (decreased blood pressure), oliguria (decreased urine volume), jaundice (yellow skin and eyes), abnormal heart and lung sounds, and signs of meningitis such as neck stiffness and photophobia can be found.
Apart from that, pain was also found throughout the body, one of which was in the calf area.
Doctors can also carry out other supporting examinations depending on the patient’s condition. The supporting examinations that can be carried out are:
- Complete blood count ( complete blood count) to see the infection as a whole
- Examination of liver function
- Examination of kidney function
- Urine and blood culture
- Leptospira immunoglobulin M (IgM) ELISA or IgM/immunoglobulin G (IgG) enzyme-linked immunoabsorbent assay (ELISA), which are rapid tests that are useful for detecting antibodies in the body.
- Real-time DNA polymerase chain reaction (PCR) to detect genetic material from Leptospira bacteria in the body
- Microscopic agglutination testing (MAT), is a serological examination that identifies leptospires.
- Lung x-ray examination, CT-scan, ultrasound, EKG to see the condition of other organs due to leptospirosis
- Cerebrospinal fluid examination
Treatment
Mild leptospirosis can generally heal on its own without special medical treatment.
Drugs such as antibiotics and fever reducers are given to help reduce the complaints that arise.
The treatment for leptospirosis that is generally given includes:
- Antibiotik, seperti doxycycline, ampicillin, amoxicillin, azithromycin, clarithromycin, ciprofloxacin, levofloxacin
- Fever reducers as well as pain relievers, such as paracetamol, ibuprofen
If the patient requires treatment in a hospital due to a result, the choices of antibiotics that can be given are:
- Intravena penicillin G
- Intravenous third-generation cephalosporins such as cefotaxime, ceftriaxone
- intravenous ampicillin or amoxicillin
- Intravena erythromycin
In addition, cases of severe leptospirosis also require other therapies to treat complications such as hemodialysis in cases of leptospirosis accompanied by complications of kidney failure to the use of a ventilator or breathing apparatus if the patient has respiratory failure.
Prevention
To avoid leptospirosis, there are several things you can do, such as:
- Cleaning the house before the flood hit. Do not let there be room for rats to stay until they poop. Mice are one of the animals that become a medium for spreading germs, apart from dogs, cats, sheep, cows and pigs
- As much as possible stay away from standing water when a flood occurs. Especially if there is a part of the body that is injured, germs can easily enter the body
- Avoid areas that may be potentially contaminated with Leptospira bacteria, such as camping near rivers or swimming in rivers
- Use personal protective equipment, such as gloves, boots, and safety glasses, when working in areas that are at risk of being infected with Leptospira bacteria, such as in ditches, rivers, animal cages, or when in flooded areas
- Covering the wound with waterproof plasters, especially when doing activities in water
- Consuming food and drinks that are guaranteed safety and cleanliness
- Wash your hands frequently after handling pets
- Maintaining the health and hygiene of pets, one of which is ensuring that the food and drink they consume are clean and carrying out vaccinations
Complications
Leptospirosis that is not handled properly can cause death. Apart from that, other leptospirosis complications that can arise include:
- Disseminated Intravascular Coagulation
- Septic shock
- Meningoencephalitis
- Lung hemorrhage
- Myocarditis
- Heart failure
- Kidney failure
- Pancreatitis
- Chronic uveitis
- Fetal Death in pregnant women
When to See a Doctor?
Immediately go to the doctor for a more detailed examination if you or one of your closest family members experiences symptoms of leptospirosis, especially if you have risk factors.
Early treatment can increase the cure rate and prevent unwanted complications.