Resumen
Definición
Anamnesis y examen
Principales factores de diagnóstico
- high remittent fever
- headache
- myalgia
- conjunctival suffusion
- muscle tenderness
Otros factores de diagnóstico
- 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
Factores de riesgo
- 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
Pruebas diagnósticas
Primeras pruebas diagnósticas para solicitar
- 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
Pruebas diagnósticas que deben considerarse
- urine culture
- abdominal ultrasound
- renal biopsy
- lung biopsy
- staining methods
- Indirect hemagglutination assay
- latex agglutination
- western blot
- quantitative PCR
- lateral flow assays
Pruebas emergentes
- cytokines
Algoritmo de tratamiento
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
Divulgaciones
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
Divulgaciones
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.
Agradecimientos
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.
Divulgaciones
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 por pares
Carmen Isache, MD
Assistant Professor of Medicine
Infectious Disease Division
University of Florida College of Medicine
Jacksonville, FL
Divulgaciones
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
Divulgaciones
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
Divulgaciones
SVS declares that he has no competing interests.
Agradecimiento de los revisores por pares
Los temas de BMJ Best Practice se actualizan de forma continua de acuerdo con los desarrollos en la evidencia y en las guías. Los revisores por pares listados aquí han revisado el contenido al menos una vez durante la historia del tema.
Divulgaciones
Las afiliaciones y divulgaciones de los revisores por pares se refieren al momento de la revisión.
Referencias
Artículos principales
Vijayachari P, Sugunan AP, Shriram AN. Leptospirosis: an emerging global, public health problem. J Biosci. 2008 Nov;33(4):557-69. Resumen
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
Artículos de referencia
Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
Diferenciales
- Hantavirus cardiopulmonary syndrome
- Dengue fever
- Malaria
Más DiferencialesGuías de práctica clínica
- Leptospirosis: clinical overview of leptospirosis
- CDC Yellow Book 2026: health information for international travel - leptospirosis
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