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Leptospirosis

Última revisão: 22 Jul 2025
Última atualização: 09 Aug 2023

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • high remittent fever
  • headache
  • myalgia
  • conjunctival suffusion
  • muscle tenderness
Detalhes completos

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
  • adenopathy
  • mental status changes
  • morbilliform rash
Detalhes completos

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 sports
  • poor living conditions/lack of sanitation
Detalhes completos

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
Detalhes completos

Investigações a serem consideradas

  • urine culture
  • renal biopsy
  • lung biopsy
  • staining methods
  • latex agglutination
  • western blot
  • quantitative PCR
Detalhes completos

Novos exames

  • lateral flow assays
  • cytokines

Algoritmo de tratamento

AGUDA

mild disease

moderate to severe disease

Colaboradores

Autores

John Fournier, MD

Clinical Fellow

Infectious Disease Section

Yale School of Medicine

New Haven

CT

Declarações

JF declares that he has no competing interests.

Albert I. Ko, MD

Professor of Epidemiology and Medicine

Department Chair

Epidemiology of Microbial Diseases

Yale School of Public Health

New Haven

CT

Declarações

AIK serves as an expert panel member for the Reckitt Global Hygiene Institute and a Board of Directors member for the American Society of Tropical Medicine. He has received grants from Zoetis and has patents which have been awarded and submitted for use in developing diagnostics and vaccines for leptospirosis.

Agradecimentos

Dr John Fournier and Dr Albert I. Ko would like to gratefully acknowledge Dr Nilmarie Guzman, a previous contributor to this topic.

Declarações

NG declares that she has 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.

Referências

Nossas equipes internas de editoria e de evidências trabalham em conjunto com colaboradores internacionais especializados e pares revisores para garantir que forneçamos acesso às informações o mais clinicamente relevantes possível.

Principais artigos

Levett P. Leptospirosis. In: Mandell, Douglas, and Bennett's principles and practice of infectious diseases. 6th ed. Philadelphia, PA: Churchill Livingstone; 2006:2495-500.

Vijayachari P, Sugunan AP, Shriram AN. Leptospirosis: an emerging global, public health problem. J Biosci. 2008 Nov;33(4):557-69. Resumo

World Health Organization. Human leptospirosis: guidance for diagnosis, surveillance and control. Geneva: World Health Organization; 2003.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.
  • Leptospirosis images
  • Differentials

    • Hantavirus cardiopulmonary syndrome
    • Dengue fever
    • Malaria infection
    Mais Differentials
  • Guidelines

    • CDC Yellow Book: health information for international travel - leptospirosis
    • Fever in returned travellers presenting in the United Kingdom: recommendations for investigation and initial management
    Mais Guidelines
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