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Leptospira infection was diagnosed as the cause of 4 late-term equine abortions/stillbirths and 1 neonatal death in Louisiana. The most consistent gross and microscopic lesions were icterus and interstitial nephritis, respectively. Diagnoses were based on visualization of compatible spirochetes in Warthin-Starry-stained sections of kidney, liver, and placenta. Confirmation by immunofluorescence was made in 2 cases.
For the purpose of identifying the frequency that enterovirus, leptospires, arbovirus cause aseptic meningitis syndrome (AMS) during non-epidemic periods and comparing patients with and without laboratory evidence for an etiologic agent, 112 patients were selected aged between 3 months and 15 years and a clinical suspicion of AMS and were referred to Couto Maia Hospital, the Infectious and Parasitic Disease Reference Center for Salvador, Bahia. In 44.6% (n=50), the etiologic agent for the diagnosis was laboratory-confirmed: enterovirus was identified in 37.7% (n=42) of the cases by the PCR Amplicor diagnostic kit, cerebrospinal fluid or fecal culture isolation; Leptospira sp. in 7.12% (n=8) by the microagglutination test; and arbovirus in non of the cases by inhibition of passive hemagglutination. In 14 of the 22 enteroviral isolates that were evaluated, 6 different serotypes were identified with Echovirus-4 being the major serotype (27.2%; 6/22) among all found (Coxsackie B2, B3, B6 and B9; Enterovirus 71). In conclusion, enteroviruses were the most frequent etiologic agent of AMS and that leptospirosis should be included in the differential diagnosis. In addition, patients with and without laboratory-confirmed identification of the etiologic agent had similar demographic and clinical characteristics and cerebrospinal fluid findings (p >0.05), therefore suggesting that patients without a confirmed diagnosis had enteroviral or leptospiral etiologies.
Superoxide dismutase (SOD) activity and the degree of lipid peroxidation were studied over a two week period in guinea pigs infected with Leptospira interrogans derived from wild mice. The total SOD activity in infected host liver increased by four-fold two days after infection; this was followed by a 20% decrease resulting in levels comparable to normal, uninfected liver. During the period of decreasing SOD activity after day two, the levels of TBA-reactive material (TBARS) are increased by three-fold in infected guinea pig, liver, compared to uninfected liver. The results indicate that SOD attenuates intracellular superoxide-mediated toxic effects in guinea pigs infected with L. interrogans. In addition, electron microscopy structure demonstrates correlated pathogenic shrinkage of mitochondrial and Kupffer cell structures.
Mongolian gerbils (Meriones unguiculatus) of Tumble Blook (TUM) and Japan Medical Science (JMS) stocks were compared with regard to susceptibility to Leptospira interrogans serovar copenhageni. The TUM gerbil died 6 to 9 d after intraperitoneal inoculation with 10 organisms, showing jaundice and systemic hemorrhage. However, 25% of the JMS gerbils survived infection with 10(3) or 10(4) organisms and there was no fatal case after infection with 10(2) organisms.
Ten non-pregnant heifers, experimentally infected with Leptospira interrogans serovar hardjo, were each given an intramuscular injection of dihydrostreptomycin at a dose rate of 25 mg kg-1. In five of these animals this treatment was repeated after 14 days. Treatment failed to remove established genital or renal infection in seven of the 10 heifers, although the number of organisms persisting was apparently reduced in these animals. Serovar hardjo infection persisted for at least 83 days in the oviduct and uterus and these tissues may be as important carrier sites for serovar hardjo as bovine kidney tissue.
Fifty sera collected from 12 different species of free-living game animals in game parks in the Northern Natal were tested against 8 Leptospira interrogans antigens using the microscopic agglutination test (MAT). Six out of 50 animals had titres, all less than 100. Three of these animals had titres to serovar mini, 1 animal to tarrasovi, and 3 animals had multi-serovar reactions, 1 to mini and hardjo, and 1 to tarrasovi, copenhageni and pomona.
Irradiated hamsters were infected with Leptospira interrogans serovar ballum in order to study the effects of impairment of the reticulo-macrophage system on the progression of the disease and the development of haemoglobinaemia. Infected and irradiated hamsters were compared with infected controls, irradiated controls and untreated controls. Red blood cells (RBCs) from untreated controls were biconcave disks while those from irradiated controls were echinocytes. Red blood cells from animals of both infected groups which were severely affected and moribund were in the form of pitted spherocytes and were associated with increased icteric indices and haemoglobinaemia. Red blood cells from less severely affected animals were echinocytic. Pitted spherocytes, however, were seen in some irradiated-infected hamsters before increased icteric indices and haemoglobinaemia were present. Both irradiated-infected and irradiated hamsters showed severe depletion of haemopoietic cells and lymphoid cells, with regeneration occurring in those animals which survived for longer. Red cell sequestration and erythrophagocytosis were present in infected-only hamsters. In irradiated-infected animals, severe anaemia was caused by both persistence of fixed macrophages, RBC sequestration and erythrophagocytosis, and haemorrhage due to vascular damage and renal papillary necrosis. A severe leucopaenia affected the irradiated hamsters' ability to suppress leptospiral multiplication resulting in the presence of larger numbers of organisms.
Plasma levels of progesterone, corticosteroids and oestrone were determined during the late stages of pregnancy in four sows experimentally infected with Leptospira pomona and in a group of three sows in which fetuses were inoculated in utero with a strain of porcine enterovirus. Only one of the seven infected sows farrowed at full term. All fetuses were dead and delivery was prolonged in litters infected with the virus. In the sows with leptospirosis almost all piglets were expelled dead or in a weak condition. The amounts of progesterone in plasma were within the normal range and showed a decrease shortly before abortion similar to that observed before parturition in normal animals. The elevation in plasma corticosteroids at normal parturtion was not seen at abortion. An irregular pattern with rising levels of plasma oestrone was found in most sows. Peak levels of oestrone were usually reached close to the time of delivery, but occured earlier in most sows which aborted well before term. In conclusion differences were noted between the endocrine patterns in normal parturition and in abortion caused by infectious agents in sows.
Thirteen sporadic cases of human leptospirosis due to Leptospira ballum were laboratory confirmed during a period of 11 yr. In four cases the diagnosis was proved retrospectively. All but three were residents of the Sharon plain region, living 10 to 15 km apart. All were engaged in some form of agriculture, especially in irrigated fields or groves, or in chicken farming. It was suspected that wet soil contaminated with the urine of rodents, carriers of L. ballum, was the main source of infection. Two types of immunological response were observed: 1) high microscopic agglutination (MA) titers with L. ballum serovar only (nine cases); and 2) considerable coagglutination titers with heterologous serovars as well (four cases). The serological follow-up of these cases for several years revealed that in some, a relatively high MA titer (1:200 to 1:400) against L. ballum serovars persisted for 4 to 9 yr. Sera from 10 patients were tested for IgM and IgG anti-bodies by the MA test. In eight cases the IgM responded to a higher titer and persisted for many years, regardless of whether or not any IgG agglutinins were detected. The importance of blood cultures is emphasized and the possibility of misinterpretation of MA results is discussed.
An outbreak of acute hemolytic disease in a large flock of sheep resulted in a mortality of approximately 5% in lambs. A diagnosis of Leptospira interrogans serotype hardjo infection was established on the basis of the presence of leptospires in the urine of one lamb, serologic findings in a guinea pig inoculated with this urine, L. hardjo titers in lambs, and pathologic findings. Prominent necropsy findings included severe icterus, thin watery blood, dark red to black kidneys and severe hemoglobinuria.
Leptospirosis was diagnosed in 11 milkers on 3 dairy farms in a Florida county. Serologic test results identified Leptospira interrogans serovar hardjo as the infecting organism in milkers and cows on one farm, and hardjo was isolated from two cows. On the second farm, serovars hardjo and pomona were implicated serologically in the cows and milkers, and pomona was isolated from two milkers. On the third farm, hardjo infection was identified by serologic tests in one milker, and hardjo was isolated from another.This was the first isolation of hardjo from a human being reported in the United States. Leptospiral infection is an occupational hazard for dairy milkers in some areas of the United States. Thus, the authors recommend that preventive measures should be taken. These measures should include boots and other protective clothing and protection from urine spray for the eyes and nose.
Pregnant hamsters were inoculated with Leptospira canicola by an intraperitoneal route. Grossly, the livers were enlarged and pale yellow. On light microscopic examination, disruption of the hepatic cords, as well as granulation of hepatocyte cytoplasm, was evident. On electron microscopic examination, the livers had evidence of severe cellular degradation as early as post-inoculation hour (PIH) 24. At PIH 96, pathologic changes were more pronounced. The rough endoplasmic reticulum was swollen and there was membrane disruption. These changes were not observed in the livers of control animals. In addition, livers of the fetuses at PIH 72 exhibited severe degenerative changes.
A case of meningitis and uveitis caused by spirochetes of the genus leptospira is reported in 21 year old man.
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