Icteric Leptospirosis - Causes, Symptoms, Diagnosis, and Treatment

Introduction

Icteric leptospirosis is a severe type of bacterial infection caused by the Leptospira bacteria known as leptospirosis, an uncommon infectious condition. Icteric leptospirosis is characterized by altered mental status, abnormal liver enlargement (hepatomegaly), persistent jaundice of the skin, mucous membranes, and eye whites, and/or malfunction of the kidneys and liver. Icteric leptospirosis typically affects people who have been with affected animals. The other names of this condition are:

• Fiedler disease.

• Weil syndrome.

• Icterohemorrhagic leptospirosis.

• Infectious jaundice.

• Spirochetal jaundice.

• Lancereaux-Mathieu-Weil spirochetosis.

• Leptospiral jaundice.

• Weil disease.

What Are the Symptoms of Icteric Leptospirosis?

Icteric leptospirosis symptoms typically appear suddenly and include the following:

• Headache.

• Confusion.

• Abdominal and muscle discomfort.

• Stiff neck.

• Anorexia (a lack of appetite).

• Chills.

• Nausea, vomiting, and fever.

Additionally, possible symptoms include:

• Prostration (extreme weakness).

• Coughing.

• Expectoration of blood-stained sputum (hemoptysis).

• Nosebleeds (epistaxis).

• Jaundice.

• Extensive muscular, gastrointestinal, and visceral organ bleeding.

• Petechiae, tiny purplish-red patches brought on by skin bleeding, may develop.

• Multiple days of swelling of the lymph nodes and fever are possible.

Icteric leptospirosis can occasionally progress to respiratory distress syndrome, which is characterized by extreme difficulty breathing and dangerously low blood oxygen levels (hypoxia).

What Are the Signs of Liver and Kidney Dysfunction in Icteric Leptospirosis?

From the third to the sixth day, symptoms of liver and renal disease typically start to show.

The presence of protein (proteinuria), pus (pyuria), blood (hematuria), or blood in the urine (hematuria), as well as an excess of urea in the blood (azotemia), are all examples of kidney disorders. The kidney's capsule is tight and frequently enlarged. The body's many capillaries, or microscopic blood vessels, could be damaged in many different locations, leading to bleeding. Thrombocytopenia, a decreased blood platelet count, can also happen. The liver is typically only slightly damaged, and full recovery nearly invariably takes place. Fever may return repeatedly for weeks, but it typically goes away on the seventh day. The prognosis for Weil syndrome is less favorable after age 50 than it is for younger persons.

What Are the Causes of Icteric Leptospirosis?

Leptospira icterohaemorrhagiae or other closely similar strains of this bacteria (such as L. canicola or L. pomona) can infect a person and result in icteric leptospirosis. The virus typically spreads to people by contact with infected domestic or wild animal tissue or urine. The mucous membranes or skin abrasion are the entry points for the infection. The following are the main causes of icteric leptospirosis:

• Animal Reservoirs: Rodents, livestock (such as cows, pigs, and sheep), dogs, and wild animals like raccoons and deer are the main carriers of the Leptospira bacteria. These animals act as the bacteria's carriers and may excrete it in their feces.

• Human Transmission: Humans can catch the infection from infected animals by coming into direct or indirect contact with their contaminated urine, tissues, or surroundings. Ingestion of tainted food or water, contact with contaminated surfaces or items, and contact with urine-contaminated water or soil are common ways to spread the disease.

• High-Risk Activities: Participating in some professional or leisure activities can make people more likely to be exposed to the germs of Leptospira. These could include involvement with animals or animal products, as well as jobs in agriculture, farming, veterinary medicine, sewage work, and water-related activities (such as swimming or kayaking in contaminated water).

• Entry Points: Cuts or abrasions in the skin or mucous membranes like the eyes, mouth, or nose are two ways that bacteria can enter the body.

• Direct Person-to-Person Transmission: Although uncommon, leptospirosis can be transferred from one individual to another through contact with contaminated bodily fluids like blood or semen.

Who Is at Risk of Icteric Leptospirosis?

All ages of people are susceptible to icteric leptospirosis. Males make up at least 75 percent of those with this disease. Although it can be an occupational condition that affects farmers, veterinarians, and sewage and abattoir employees, the majority of patients are unintentionally exposed while engaging in recreational activities.

How Is Icteric Leptospirosis Diagnosed?

It could be challenging to get a diagnosis if one only has a minor case of leptospirosis. The signs and symptoms frequently match those of other illnesses, like the flu, because the symptoms of Weil's disease are more severe, it is simpler to diagnose. The doctor will probably begin by gathering the medical background in order to establish a diagnosis. Inform the doctor if one:

• Has lately been on a trip.

• Has engaged in aquatic activities.

• Has come into contact with a source of fresh water.

• Has a job that requires handling animals or animal products.

The healthcare provider may request blood testing, urine tests, or maybe both if they think one has leptospirosis or another bacterial illness.

The blood or urine can be tested in a lab to see if Leptospira bacteria are present. The doctor may also order chest X-rays and more blood tests to examine the health of the kidneys and liver to determine if the patient has Weil's disease or icteric leptospirosis. The healthcare provider can also determine which organs may have an infection by using scans and testing.

How Is Icteric Leptospirosis Treated?

Antibiotics are frequently used in conjunction with supportive care to treat icteric leptospirosis. The following are the main elements of the therapy:

• Hospitalization: For close observation and complication management, patients with icteric leptospirosis frequently need to be admitted.

• Replacement of Fluid and Electrolytes: Intravenous fluid therapy is used to keep patients hydrated and to restore any electrolyte imbalances brought on by dehydration or renal damage.

• Treatment with Antibiotics: To get rid of the Leptospira bacteria inflicting the infection, antibiotics are administered. The choice of antibiotic is influenced by regional patterns of resistance and the severity of the illness. Doxycycline, Penicillin, Ampicillin, and Ceftriaxone are examples of antibiotics that are often used. Although the length of the antibiotic therapy can vary, it is usually given for at least a week.

• Supportive Care: Treatment includes addressing symptoms and side effects. This may involve liver protection measures, painkillers, antiemetics for motion sickness, and drugs to manage fever. If the condition is severe, intensive care treatment may be required for organ support, dialysis, or breathing support.

• Monitoring and Follow-Up: Throughout treatment, it is crucial to routinely check vital signs, liver function, renal function, and other important factors. To guarantee full healing and to address any residual problems or symptoms, follow-up visits are planned.

Conclusion

Icteric leptospirosis, often known as Weil's disease, is a severe variation of leptospirosis that includes liver involvement and jaundice. It results from the infection with the Leptospira bacteria, which is often spread from animals to people. Prompt medical intervention is necessary for proper management and better results. Preventative actions, such as maintaining excellent hygiene and avoiding polluted areas, can help lower the risk of infection.