Leptospirosis Clinical Disease and Diagnosis in Humans

A presented by Renee Galloway, US Centers for Disease Control and Prevention and hosted by the Otago Global Health Institute.

Leptospirosis is a bacterial illness caused by the spirochete Leptospira. Humans become infected through contact with contaminated animal urine. Leptospirosis presents as a flu-like illness, although severe illness can result in very different syndromes, ranging from kidney and liver failure to severe pulmonary hemorrhagic syndrome to aseptic meningitis. Most illness is mild, but 5-15% progress to multi-organ failure. Diagnosis is challenging due to the myriad of clinical symptoms and similarity to other infectious diseases. Early treatment can lessen the severity of leptospirosis, so prompt diagnosis is critical. Serology is the most common diagnostic method, but the gold standard assay is cumbersome and difficult to perform. Detection of DNA by PCR is confirmatory, but the window for optimal specimen collection is very narrow due to the transient nature of Leptospira in the bloodstream. A multifaceted approach using both serology and molecular detection is recommended for the diagnosis of leptospirosis.

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