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Microbiology, epidemiology, clinical manifestations, and diagnosis of leptospirosis

INTRODUCTION

Leptospirosis is a zoonosis with protean manifestations caused by the spirochete, Leptospira interrogans. Synonyms for the disease include Weil's disease, Swineherd's disease, rice-field fever, cane-cutter fever, swamp fever, mud fever, hemorrhagic jaundice, Stuttgart disease, and Canicola fever.

The microbiology, epidemiology, clinical manifestations, and diagnosis of leptospirosis will be presented here. The treatment and prevention of this disease are discussed separately. (See "Treatment and prevention of leptospirosis".)

MICROBIOLOGY

The genus Leptospira consists of two species, L. interrogans and L. biflexia, only the former of which is known to cause human disease. More than 200 serovars of L. interrogans have been identified. Leptospira are spiral-shaped aerobic spirochetes with 18 or more coils per cell. They tend to stain poorly with common laboratory stains and are best visualized by dark field microscopy, silver stain or fluorescent microscopy.

Unlike the clinically important spirochete Treponema pallidum, L. interrogans can be grown in vitro from clinical specimens including blood, urine, and cerebrospinal fluid (CSF). Special media are required for isolation such as Fletcher's, Ellinghausen's, or polysorbate 80 media. Therefore, the laboratory needs to be notified if an attempt to isolate leptospira is desired. Growth is usually observed in one to two weeks but may take up to three months [1].

Whole genome-sequencing of a representative virulent strain of L. interrogans has identified a series of genes possibly related to adhesion, invasion, and the hematological changes that characterize leptospirosis, allowing in depth studies of virulence and pathogenesis [2].

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Last literature review version 18.2: May 2010
This topic last updated: March 23, 2010
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