Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- presença de fatores de risco
- febre alta remitente
- cefaleia
- mialgia
- sufusão conjuntival
- Sensibilidade muscular
Outros fatores diagnósticos
- calafrios
- dor abdominal
- náuseas ou vômitos
- diarreia
- astenia
- anorexia
- fotofobia
- dor ocular
- rigidez de nuca
- tosse
- dispneia
- dor torácica
- hemoptise
- oligúria ou poliúria
- arritmia cardíaca
- linfadenopatia
- esplenomegalia
- hepatomegalia
- icterícia
- adenopatia
- alterações do estado mental
- Erupção cutânea morbiliforme
Fatores de risco
- contato (direto ou indireto) com a urina de animais infectados
- residência em/ou viagem para uma área endêmica
- residência em/ou viagem para uma área com enchente recente
- envolvimento em esportes aquáticos
- pobreza/falta de saneamento
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- hemograma completo e diferencial
- urinálise
- teste de aglutinação microscópica
- ensaio de imunoadsorção enzimática (ELISA)
- reação em cadeia da polimerase
- exame de campo escuro
- hemocultura
- cultura do líquido cefalorraquidiano (LCR)
- eletrocardiograma (ECG)
- radiografia torácica
- TFHs
- bilirrubina conjugada
- perfil metabólico
- enzimas pancreáticas séricas
- análise do líquido cefalorraquidiano (LCR)
Investigações a serem consideradas
- urocultura
- biópsia renal
- biópsia pulmonar
- métodos de coloração
- aglutinação em látex
- Western Blot
- reação em cadeia da polimerase quantitativa
Novos exames
- ensaios de fluxo lateral
- Citocinas
Algoritmo de tratamento
doença leve
doença moderada a grave
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
Раскрытие информации
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.
Выражение благодарностей
Dr John Fournier and Dr Albert I. Ko would like to gratefully acknowledge Dr Nilmarie Guzman, a previous contributor to this topic.
Раскрытие информации
NG declares that she has no competing interests.
Рецензенты
Carmen Isache, MD
Assistant Professor of Medicine
Infectious Disease Division
University of Florida College of Medicine
Jacksonville
FL
Раскрытие информации
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
Раскрытие информации
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
Раскрытие информации
SVS declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
Список литературы
Основные статьи
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. Аннотация
World Health Organization. Human leptospirosis: guidance for diagnosis, surveillance and control. Geneva: World Health Organization; 2003.Полный текст
Centers for Disease Control and Prevention: National Notifiable Diseases Surveillance System (NNDSS). Leptospirosis (Leptospira interrogans) 2013 case definition. Apr 2021 [internet publication].Полный текст
Статьи, указанные как источники
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Отличия
- Síndrome cardiopulmonar por hantavírus
- Febre da dengue
- Infecção malárica
Больше ОтличияРекомендации
- CDC Yellow Book: health information for international travel - leptospirosis
- National leptospirosis service
Больше Рекомендации
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