Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- high remittent fever
- headache
- myalgia
- conjunctival suffusion
- muscle tenderness
Outros fatores diagnósticos
- chills or rigors
- abdominal pain
- nausea or vomiting
- diarrhea
- asthenia
- anorexia
- photophobia
- eye pain
- neck stiffness
- cough
- dyspnea
- chest pain
- hemoptysis
- oliguria or polyuria
- cardiac arrhythmias
- lymphadenopathy
- splenomegaly
- hepatomegaly
- jaundice
- lymphadenopathy
- mental status changes
- morbilliform rash
Fatores de risco
- contact (direct or indirect) with urine of infected animals
- residence in or travel to an endemic area
- residence in or travel to an area with recent flooding
- involvement in water or adventure sports
- substandard housing or inadequate access to basic sanitation
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- CBC and differential
- urinalysis
- microscopic agglutination test (MAT)
- enzyme-linked immunosorbent assay (ELISA)
- polymerase chain reaction (PCR)
- darkfield examination
- blood culture
- cerebrospinal fluid (CSF) culture
- ECG
- chest x-ray
- LFTs
- conjugated bilirubin
- metabolic profile
- serum pancreatic enzymes
- CSF analysis
Investigações a serem consideradas
- urine culture
- abdominal ultrasound
- renal biopsy
- lung biopsy
- staining methods
- Indirect hemagglutination assay
- latex agglutination
- western blot
- quantitative PCR
- lateral flow assays
Novos exames
- cytokines
Algoritmo de tratamento
mild disease
moderate to severe disease
Colaboradores
Autores
Molly Erin Fleece, MD, FIDSA
Associate Professor
Division of Infectious Diseases
Department of Medicine
University of Alabama at Birmingham
Birmingham, AL
Declarações
MEF declares that she has no competing interests.
Stefania Carmona, MD
Assistant Professor
Division of Infectious Diseases
Department of Medicine
University of Alabama at Birmingham
Birmingham, AL
Declarações
SC has received a professional services fee as an author of the Merck Manual Professional Version and the Merck Manual Consumer Version - Arboviruses, Arenaviridae, and Filoviridae chapters.
Agradecimentos
Dr Molly Erin Fleece and Dr Stefania Carmona would like to gratefully acknowledge Dr John Fournier, Dr Albert I. Ko, and Dr Nilmarie Guzman, previous contributors to this topic.
Declarações
AIK has been reimbursed for participation in the Research Advisory and Advocacy Committee for the Reckitt Global Hygiene Institute. JF and NG declare that they have no competing interests.
Revisores
Carmen Isache, MD
Assistant Professor of Medicine
Infectious Disease Division
University of Florida College of Medicine
Jacksonville, FL
Declarações
CI declares that she has no competing interests.
Andreas Jansen, MD, DTM
Scientific Officer
Robert Koch Institute
Department for Infectious Disease Epidemiology
Gastrointestinal Infections
Zoonoses and Tropical Infections Unit
Berlin
Germany
Declarações
AJ declares that he has no competing interests.
Sean V. Shadomy, DVM, MPH
Epidemiologist
Bacterial Zoonoses Branch
DFBMD/NCZVED/CCID
Centers for Disease Control and Prevention
Atlanta, GA
Declarações
SVS declares that he has no competing interests.
Créditos aos pareceristas
Os tópicos do BMJ Best Practice são constantemente atualizados, seguindo os desenvolvimentos das evidências e das diretrizes. Os pareceristas aqui listados revisaram o conteúdo pelo menos uma vez durante a história do tópico.
Declarações
As afiliações e declarações dos pareceristas referem--se ao momento da revisão.
Referências
Principais artigos
Vijayachari P, Sugunan AP, Shriram AN. Leptospirosis: an emerging global, public health problem. J Biosci. 2008 Nov;33(4):557-69. Resumo
Centers for Disease Control and Prevention. CDC Yellow Book 2026: health information for international travel. Section 4: travel-associated infections and diseases - leptospirosis. Apr 2025 [internet publication].Texto completo
World Health Organization. Human leptospirosis: guidance for diagnosis, surveillance and control. Geneva: World Health Organization; 2003.Texto completo
Centers for Disease Control and Prevention. Leptospirosis: clinical overview of leptospirosis. Feb 2026 [internet publication].Texto completo
Centers for Disease Control and Prevention: National Notifiable Diseases Surveillance System (NNDSS). Leptospirosis (Leptospira interrogans) 2013 case definition. Apr 2021 [internet publication].Texto completo
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
Diagnósticos diferenciais
- Hantavirus cardiopulmonary syndrome
- Dengue fever
- Malaria
Mais Diagnósticos diferenciaisDiretrizes
- Leptospirosis: clinical overview of leptospirosis
- CDC Yellow Book 2026: health information for international travel - leptospirosis
Mais Diretrizes
Conectar-se ou assinar para acessar todo o BMJ Best Practice
O uso deste conteúdo está sujeito ao nosso aviso legal