Which lab studies are performed to screen for and diagnosis leptospirosis?

Updated: Jul 08, 2021
  • Author: Sandra G Gompf, MD, FACP, FIDSA; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

Laboratory studies used to screen for the diagnosis of leptospirosis include the following:

  • Leptospira immunoglobulin M (IgM) ELISA or IgM/immunoglobulin G (IgG) enzyme-linked immunoabsorbent assay (ELISA), including rapid diagnostic kits usable in the field
  • Real-time DNA polymerase chain reaction (PCR) of blood, urine, and cerebrospinal fluid (CSF)

Laboratory studies used to confirm the diagnosis of leptospirosis include the following:

  • Microscopic agglutination testing (MAT; criterion standard for serologic identification of leptospires, available at reference laboratories)
  • Single titer ≥1:200 or 4-fold rise in serum drawn between the first and fourth week of illness is considered diagnostic
  • DNA PCR of blood, urine, CSF, tissue
  • Culture of leptospires from body fluids or tissue (criterion standard, but requires specific media and several weeks’ incubation, thus usually limited to reference laboratory)

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