* Tank: rodents; livestock (cattle); dog.
Disposal -> urine.
* Transmission can be direct rat bite (rare); Leptospira enter the body through wounds and erosions of the skin or mucous membranes, the conjunctiva, inhalation or ingestion of aerosol droplets or contaminated fluids.Occupational hazard (sewer workers …).
* Urinary excretion of leptospires begins on day 12.
Transmission can be direct rat bite (rare); leptospires enter the body through wounds and erosions of the skin or mucous membranes
* The sudden onset sit: sepsis, pain syndrome (myalgia), mucocutaneous signs (conjunctival suffusion), meningeal syndrome (fickle).
Bacteremic this phase lasts 3-7 days; inconstant fever outbreak occurs on the 15th day (in the absence of treatment).
* Visceral injuries appear from the 3rd day (precocity of their appearance would be a serious argument.
– Liver disease (70%): flamboyant jaundice; the conjugated bilirubins is high
– Renal disease (50-70%): proteinuria and pyuria; favorable
– Neurological disease: lymphocytic meningitis (50%)
– Hemorrhagic Events: epistaxis, gingival bleeding, hematemesis ….
– Other: lung (30%) with cough, hemoptysis; heart (5%) with myocarditis; eye (5%) with uveitis, chorioretinitis, iridocyclitis.
* NFS: leukocytosis with neutrophilia
* Direct Examination: blood (the first 5 days); LCR (the first 5 days); urine (from 12 days).
Between the 6th and 12th day (dumb phase laboratory).
* Serology: the reference reaction is the microscopic agglutination Martin and Petit MAT (after the 10th-12th day)
* Other (serology): the blade on macro-agglutination using Ag TR (common to several Leptospira); ALISA or methods.
* Treatment: Penicillin G; in case of allergy -> doxycycline. (10j or more duration). Prophylaxis -> vaccination.
