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PubMed1986

Morphological changes in red blood cells of calves caused by Leptospira interrogans serovar pomona.

Haemoglobinaemia is seen in certain hosts infected by certain serovars of Leptospira interrogans, but is absent from other serovar-host associations. Comparisons were made between calves infected with serovar pomona and those receiving a crude "toxin" prepared from the same organism. Red blood cells from "toxin"-injected calves showed discocyte-echinocyte transformation and contained portions of cytoplasm segregated within vacuoles. These animals showed increased sequestration of RBCs within the spleen but no overt haemoglobinaemia. Red blood cells from infected and haemoglobinaemic animals were spherical and pitted. They also showed vacuoles and tracts under the cell membrane in fully haemoglobinized RBCs and dark granular inclusions within the cytoplasm of those which were only partially haemoglobinized. Intracellular leptospires were not seen within the RBCs. Red blood cell sequestration and erythrophagocytosis were very pronounced within the spleen, liver and bone marrow. The changes in the RBCs are not easily explained by the previously proposed theory that RBC destruction is due to a phospholipase-like toxin acting directly upon the RBC membrane. A more appropriate hypothesis is that the RBC lesions are due to the adverse effects of leptospiral "toxin(s)" on the metabolism of the RBC causing the formation of defective portions of cytoplasm. These are then either degraded and expelled, leaving empty vacuoles, or are degraded and left within the cytoplasm as dark granular inclusions.

Animals↗
PubMed1986

Dual infections of red deer (Cervus elaphus) by Leptospira interrogans serovars copenhageni and hardjo.

On a property in the Nelson District, blood and urine samples were taken from red deer (Cervus elaphus) from which low (<1:100) antibody titres to serovar copenhageni and suspected leptospiral abortions had previously been reported. A total of 27 hinds were sampled. Microscopic agglutination test (MAT) titres in sera ranging from 1:32 to 1:128 were found in six animals. Thirteen leptospiral isolations were made from nine of the 27 urine samples. Four of these were typed as copenhageni and nine as hardjo. Two cultures were prepared from each urine sample and hardjo and copenhageni were both isolated from single urine samples from two animals. None of the 27 deer had serum MAT titres at 1:32 or above to copenhageni.

Journal Article↗
PubMed1969

Q fever and leptospirosis in the dairy farming community and allied workers of Worcestershire.

Sera collected from dairy farmers, their families and farm workers, slaughtermen, artificial inseminators, veterinarians, and a group of doctors and civil servants with no direct connexion with farming were examined for evidence of Q fever or leptospirosis. One thousand and fifty-two sera examined for Q fever yielded 26% of positive results with titres of complement-fixing antibody through 1 in 4 to 1 in 128 and over. On the other hand, 876 sera examined for agglutinating antibody to various leptospirae showed only 0.5% of positive titres of 1 in 80 and over. None of the individuals with positive sera for Q fever had ever been ill with anything resembling Q fever or could remember any ill health in the past; this suggests subclinical infection. One farmer with a high titre against L. copenhageni (icterohaemorrhagiae) gave a history of a recent febrile illness very suggestive of acute leptospirosis. Infection due to leptospirae appeared to be very much less common than that due to C. burneti.

Adolescent↗
PubMedDate not supplied

Asymptomatic infection and risk factors for leptospirosis in Nicaragua.

As part of an investigation of a 1995 outbreak of leptospirosis in Nicaragua, a cross-sectional serologic survey was conducted in the town of El Sauce. Of 566 persons, 85 (15%) were positive for IgM anti-Leptospira antibodies, indicating recent leptospirosis infection. Asymptomatic leptospirosis infection was common, with only 25 (29.4%) of the 85 seropositive inhabitants reporting a febrile illness in the 2 months before the survey. Multivariable analysis revealed that having an indoor water source remained independently protective against leptospirosis. Gathering wood was independently associated with infection. These findings suggest that asymptomatic infection with Leptospira is common in endemic areas of Leptospira transmission. Improvement in water sanitation and behavioral modifications to reduce environmental exposure may reduce the risk of leptospirosis in endemic regions.

Adolescent↗
PubMed2000

[Simultaneous leptospirosis and hantavirus infection in the same patient].

The leptospirosis and the hantaviral infections are worldwide distributed zoonoses having the similar epidemiology and clinical symptoms. Both in Europe and Asia those hantaviral serotypes are common which are responsible for the haemorrhagic fever with renal syndrome, while on the American continent the hantaviral pulmonary syndrome has also been diagnosed. Authors describe a patient who had simultaneous leptospira and hantaviral infections with haemorrhagic fever as well as with mild, transient renal insufficiency and liver damage. The dual infection was proved by serology.

Diagnosis, Differential↗
PubMed2005

[Clinical and epidemiological features of leptospirosis in Bolívar state, Venezuela. Comparison of diagnostic methods: LEPTO-Dipstick and plaque macroscopic agglutination test].

Leptospirosis is caused by numerous serovars of Leptospira interrogans. The infection is acquired through the contact of softened skin, mucous and conjunctive with the urine of animals and humans infected by animal carriers. The aim of this study was to determine the clinical and epidemiological features of leptospirosis in Bolívar state Venezuela and to compare the sensibility and specificity of the LEPTO-Dipstick, with the test of macroscopic agglutination in plate with the termorresistent antigen (TR). Thirty one sample of serums were processed of patients with leptospirosis clinic, admitted in the Hospital Universitario "Ruiz y Páez" of Ciudad Bolívar during 12 months. Detection IgM antibodies of anti-Leptospiras was carried out by means of LEPTO-Dipstick and antigen TR. The Microscopic Agglutination Test (MAT) was also, carried out. The general prevalence of leptospirosis in patients who attended the "Ruiz y Paez" Hospital was of 80.6% (n = 25) by means of the determination of the termorresistent antigen. The most frequent serovars identified in Bolívar State, were the serovars: icterohaemorrhagiae, copenhageni (21.3%), autummalis and australis (12.8%). TR antigen and LEPTO Dipstick had a sensibility of 80% and a specificity of 25%. The agreement between both methods was null (Kappa: -0.2). Bolívar state has a high leptospirosis prevalence and the infection should be discarded in those patients with long-term fever and risk factors for the illness.

Adolescent↗
PubMed1985

[Differences in the susceptibility of field mice from the Altai Territory and Moscow Province to Leptospira of serovar mozdok and serogroup Pomona].

Adult striped field mice (Apodemus agrarius) caught in the Altai region proved to be insusceptible to experimental infection when inoculated with Leptospira of serovar mozdok, serogroup Pomona. In pregnant females, though infected with this organism, no leptospiruria was observed. At the same time nonpubescent animals became Leptospira carriers, females becoming carriers 4.5 times more frequently than males. The formation of antibodies to Leptospira in the test rodents was poorly pronounced and did not depend on their sex, age, physiological state and the presence of renal leptospirosis. But all adult striped field mice belonging to the population of the Moscow region became Leptospira carriers in such experiments.

Aging↗
PubMed1981

A minireview of the pathogenesis of acute leptospirosis.

Hemorrhagic diathesis is one of the most striking manifestations in acute leptospirosis. Hemorrhages are seen in infections due to Leptospira icterohaemorrhagiae as well as in those caused by Leptospira pomona. Thrombocytopenia is a constant feature and its finding can be useful for the diagnosis. Attempts to demonstrate the presence of a toxin in leptospires were unsuccessful. A few years ago, a syndrome of disseminated intravascular coagulation was associated with the physiopathogenesis of experimental leptospirosis with L. icterohaemorrhagiae. More recently, this syndrome was identified in cases of human leptospirosis and in hamsters infected with L. pomona. It appears now that other spirochetal infections (borreliosis) have a similar pathogenesis. Nonetheless, many points are still unclear: the primary cause of disseminated intravascular coagulation is unknown, as well as the virulence factors of spirochetes. Some points favor the presence of a toxic factor in leptospires: vascular damage that occurs in the absence of leptospires in damaged areas and the fact that antibiotic therapy is ineffective unless treatment is initiated early in the disease.

Acute Disease↗
PubMed1993

Infections in an Alpine environment: antibodies to hantaviruses, leptospira, rickettsiae, and Borrelia burgdorferi in defined Italian populations.

From 1987 to 1991, a seroepidemiologic survey for antibodies to hantaviruses, leptospira, rickettsiae, and Borrelia was conducted in selected Italian population groups. In the mountainous areas of northeastern Italy, the prevalence of antibody to hantaviruses, as detected by indirect immunofluorescent antibody (IFA) assay, was 7.1%, 4.8%, 4.3%, and 4% in 265 forestry workers, 82 rangers, 395 farmers, and 75 hunters, respectively. Among 299 Alpine soldiers, the prevalence was lower (0.7%). Of those with Hantaan antibody, the reactivity pattern using Hantaan, Puumala, and Fojnica viruses suggested a prevalence of antibody to Hantaan virus, with titers reaching levels of 128. The presence of leptospiral antibodies (by microagglutination test), which included the prevalence of antibodies to Leptospira icterohaemorrhagiae, L. bratislava, and L. saxkoening serotypes, was observed in 10-12% of the farmers and forestry workers in these Alpine mountain regions. Only a few sporadic clinical cases of leptospirosis have been reported from these regions. Antibodies to Borrelia burgdorferi (by IFA) were observed in 19% of the rangers and forestry workers, with lower values in farmers (10%) and hunters (8%). These data suggest the presence of a large number of asymptomatic infections with B. burgdorferi and the leptospires in the densely wooded areas of the Alpine Italian regions. Furthermore, the recent identification of a case of Hantaan acute nephropathy in a man living in the mountainous northeastern area of Italy confirms the presence of hantavirus in the Italian Alpine zones, especially those near the Slovenian border.

Adult↗
PubMedDate not supplied

Risk factors associated with leptospirosis in northeastern Thailand, 1998.

Leptospirosis is a zoonotic disease of worldwide distribution caused by spirochetes of the genus Leptospira. Humans are infected through direct contact with infected animals or through exposure to fresh water or soil contaminated by infected animal urine. Leptospirosis is characterized by acute fever that can be followed by a more severe, sometimes fatal illness that may include jaundice and renal failure (Weil's disease), meningitis, myocarditis, hemorrhagic pneumonitis, or hemodynamic collapse. To identify potential risk factors for leptospirosis in Thailand, we conducted a matched case-control study in Nakornratchasrima Province of the northeastern region. Fifty-nine cases and 118 controls were included in the study. Four activities in the two weeks prior to illness were independently associated with leptospirosis infection: walking through water (odds ratio [OR] = 4.9, 95% confidence interval [CI] = 1.7-14.1), applying fertilizer in wet fields for more than 6 hr a day (OR = 3.4, 95% CI = 1.5-7.8), plowing in wet fields for more than 6 hr a day (OR = 3.5, 95% CI = 1.1-11.6), and pulling out rice plant sprouts in wet fields for more than 6 hr a day (OR = 3.1, 95% CI = 1.02-9.3). Identification of these risk factors on admission might prove useful for early diagnosis and treatment of leptospirosis in Thailand.

Adolescent↗
PubMed1994

Leptospirosis complicated by a Jarisch-Herxheimer reaction and adult respiratory distress syndrome: case report.

Leptospirosis, severe infection due to Leptospira interrogans, is a potentially lethal disease that causes multiple organ failure. In addition to hepatic, renal, and CNS involvement, which are classic complications of leptospirosis, the disease may also be complicated by adult respiratory distress syndrome. Treatment with penicillin may precipitate a severe Jarisch-Herxheimer reaction. The mechanisms of Leptospira-induced toxicity remain obscure. We report a near-fatal case of leptospirosis in a patient who developed a JHR and respiratory failure immediately after initiation of therapy.

Drug Eruptions↗
PubMed1991

Specific immunofluorescence staining of Treponema pallidum in smears and tissues.

To date, tissue sections prepared from Formalin-fixed tissues have not been successfully stained with Treponema pallidum subspecies-specific antibody in a direct fluorescent-antibody assay. While current methods stain T. pallidum, they do not distinguish T. pallidum from other spirochetes such as Borrelia burgdorferi (E. F. Hunter, P. W. Greer, B. L. Swisher, A. R. Simons, C. E. Farshy, J. A. Crawford, and K. R. Sulzer, Arch. Pathol. Lab. Med. 108:878-880, 1984). Because trypsin pretreatment of tissue sections has enhanced other immunofluorescent-antibody (IFA) applications, we compared the use of the trypsin digestion method with the current 1% ammonium hydroxide (NH4OH) method as a means to obtain specific staining of T. pallidum in tissues by both direct and indirect IFA techniques. Pretreated T. pallidum-infected tissues sections from rabbits, hamsters, and humans were quantitatively examined with the direct fluorescent-antibody-T. pallidum test conjugate absorbed with Treponema phagedenis, the Reiter treponeme. For indirect staining, a serum specimen from a patients with syphilis absorbed by affinity chromatography with T. phagedenis was used as the primary reagent, and a fluorescein isothiocyanate-labeled rabbit anti-human globulin was used as the secondary reagent. Serum specificity was established first by examining antigen smears of T. pallidum subsp. pallidum, T. pallidum subsp. pertenue, B. burgdorferi, T. phagedenis, and Treponema denticola MRB and then by examining tissues infected with these pathogens plus those infected with four Leptospira serovars. When we stained tissue using the direct IFA method that is currently a standard method for the examination of chancre smears, we found it to be unsuitable for use with tissue. Trypsin digestion did not offer an improvement over the NH4OH pretreatment method in the specific identification of T. pallidum by direct IFA. However, specific identification of T. pallidum in tissue sections was obtained by the indirect IFA technique after either trypsin or NH4OH pretreatment.

Animals↗
PubMed1979

[On the leptospirosis occurred in a worker under construction of World Ocean Exposition in Okinawa Prefecture (author's transl)].

A male worker, 29 years old, was engaged in construction work of World Ocean Exposition in Okinawa Perfecture, and was diagnosed as suffering from leptospirosis in September 1973. The leptospirosis was an acute infection caused by Leptospira hebdomadis. The parasite seemed to be transmitted to him by ingestion of food and drink contaminated with the urine and excreta of the reservoir animals in the unsanitary workshop and living environment in Okinawa district. This leptospirosis was determined as an occupational disease.

Adult↗
PubMed2002

Leptospirosis: skin wounds and control strategies, Thailand, 1999.

After an outbreak of leptospirosis in workers who participated in cleaning a pond during September 1999 in Thailand, a serologic survey was conducted. Among a cohort of 104 persons from one village who participated in pond cleaning activity, 43 (41.3%) were seropositive for immunoglobulin M antibodies against Leptospira, indicating recent infection. Only 17 (39.5%) of 43 seropositive persons reported a recent febrile illness; the remaining seropositive persons were considered asymptomatic, suggesting that asymptomatic leptospirosis infection may be common where leptospirosis is endemic. Multivariable logistic regression indicated that wearing long pants or skirts was independently protective against leptospirosis infection (OR(adjusted) = 0.217), while the presence of more than two wounds on the body was independently associated with infection (OR(adjusted) = 3.97). Educational efforts should be enhanced in areas where leptospirosis is endemic to encourage the use of protective clothing. In addition, wound management and avoidance of potentially contaminated water when skin wounds are present should be included in health education programs.

Adolescent↗