Classic features in severe disease (sometimes known as Weil’s disease) include:
- Fever
- Jaundice
- Acute kidney injury
- Conjunctival suffusion
Presentation can be highly variable; some but not all may present with a biphasic illness with an early febrile phase followed by an immune inflammatory phase.
Other findings may include:
- Myalgia
- Hepatosplenomegaly
- Lymphadenopathy
- Pulmonary involvement (e.g. haemorrhage, ARDS)
- Cardiac involvement (e.g. myocarditis, conduction abnormalities)
- Aseptic meningitis
Diagnosis:
- Serology: Detection of IgM antibodies to Leptospira- usually later in the illness
- Detection of Leptospira in blood or urine- early in illness either by microscopy, culture or PCR.
Leptospirosis is a notifiable disease in the UK.
