Leptospirosis caused by spirochetes

The article is professionally consulted by Master, Doctor Le Thi Minh Huong - Emergency Medicine Doctor - Department of Resuscitation - Emergency - Vinmec Nha Trang International General Hospital. The doctor has more than 06 years of experience in examining and treating internal diseases, emergency and emergency resuscitation.

Leptospira is an infectious disease transmitted by animals to humans that causes high fever, headache, and muscle pain. Animals that transmit disease include: rats are the most common. In addition, dogs, pigs, wild animals, fish and birds can also transmit the disease. The disease manifests itself in many different forms, in which severe form manifests as jaundice, hepatitis, impaired renal function and bleeding, also known as Weil's syndrome. Suitable conditions for spirochetes to develop and spread disease are tropical climate, poor sanitation, farming, vegetable growing, livestock raising, sanitation workers dredging sewers, slaughtering livestock, fish, bathing. in ponds and lakes in contact with water contaminated with Leptospira.

How is Leptospirosis transmitted? Humans transmit the disease by direct contact with the urine, blood, and tissues of infected animals. The disease can develop into an epidemic due to water contaminated with spirochetes of Leptospira because the spirochetes excrete urine into the environment. It can also be transmitted from person to person, but is rare. Leptospira causes damage to endothelial cells leading to inflammation of blood vessels especially capillaries leading to damage to organs. Specifically: + In the kidney, spirochetes penetrate into the interstitial space, the renal tubules cause interstitial inflammation and tubular necrosis, renal failure due to lack of water or increased vascular permeability causing a decrease in circulating volume.
+ In the liver, spirochetes cause necrosis of the lobules center, infiltrating hepatocytes.
+ Lung damage as a result of bleeding. Muscle damage includes fibromyalgia and focal necrosis.
+ In severe Leptospira infection, inflammation of the vessels, especially capillaries, causes increased vascular permeability, microcirculatory disturbances leading to fluid drainage, decreased circulating volume, and consequent shock and collapse.

The disease may be asymptomatic in some patients. Most are mild with no jaundice, with or without meningitis, a few are severe with dark jaundice.
Symptoms of leptospirosis occur in 2 stages.
Stage I: lasts 5-7 days, begins suddenly with symptoms including: High fever, vomiting, diarrhea, red eyes, muscle aches, rash with swinging pain Stage II: occurs 1 -2 weeks later with manifestations such as: yellowing of the skin and eyes, oliguria, anuria, cardiac arrhythmias, manifestations of meningitis.

Treat with antibiotics to destroy spirochetes, use antibiotics early according to indications, at the right dose and time to kill spirochetes completely. Severe leptospirosis should be monitored and treated in the intensive care unit. Adequate fluid replacement by intravenous infusion ensures circulating volume and maintains a stable blood pressure. In the case of patients with anuria and renal failure, early hemodialysis should be indicated. Transfusion of whole blood or platelets in case of need according to indications. Ensure airway circulation by suctioning sputum, administering oxygen, intubating, and mechanically venting when necessary. Use vitamin K , diuretics and anti-hepatocellular necrosis if necessary.

Manage livestock to avoid discharge of urine and feces directly into drains, ponds and lakes, causing water pollution. Vaccinate animals and monitor diseases in animals. Kill rats Use labor protection for people at high risk such as wearing gloves, boots, swimming goggles,.. Do not bathe in lakes and ponds Vaccinate against Leptospira. Most people who get enough vaccinations have good immunity for 3 years. Prophylaxis with anti-nutritional drugs according to indications for those suspected of being infected during an epidemic can be prevented.