Leptospirosis

Leptospirosis is a zoonosis caused by infection with pathogenic Leptospira species. The disease occurs worldwide and is regarded as a re-emerging infection. Transmission occurs directly through contact with infected animals or indirectly through contact with contaminated water or soil. Leptospirosis has a wide spectrum of clinical manifestations, ranging from mild self-limited febrile illness to severe multiorgan failure with high mortality rates. Disease caused by Leptospira of the serogroup Icterohaemorrhagiae appears to follow the severe course more frequently than for other serogroups. Due to the nonspecific nature of the initial presentation, a high level of suspicion is required to make the diagnosis. Antibiotic treatment is often initiated before definitive diagnosis, as treatment shortens the duration of the illness and reduces mortality. Travelers to tropical areas must be educated about the risks of fresh water exposure, and doxycycline chemoprophylaxis should be offered, especially for high-risk activities such as swimming and rafting.