Leptospirosis.

Abstract

Leptospirosis, a waterborne spirochetal illness, is common in tropical climates. Rodents and wild animals are the most common reservoirs for this widespread zoonosis. Human disease is acquired by contact with urine or tissues of an infected animal or through contaminated water and soil. Systemic leptospirosis is characterized by its multisystem involvement, protean manifestation, and varying severity. The clinical presentation ranges from occult infection to fatal complications like hepatorenal failure. Early diagnosis is important to halt the fulminate course. The microagglutination test is considered the gold standard serological test for leptospirosis, although molecular techniques are now under study. Treatment of systemic leptospirosis includes penicillin or tetracycline in addition to supportive treatment. Ocular involvement occurs during the immunological phase of the disease. One or both eyes may be involved, typically with a panuveitis often accompanied by retinal periphlebitis and hypopyon. In general, leptospiral uveitis has a good prognosis and the patient recovers full vision in spite of severe panuveal inflammation. Awareness of this infectious uveitic entity is essential not only in order to differentiate it from other severe autoimmune uveitides, but also to reduce the percentage of idiopathic uveitis in endemic areas.