What is the initial presentation of leptospirosis?

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

In 90% of cases, leptospirosis manifests as an acute febrile illness with a biphasic course and an excellent prognosis. Nonspecific signs and symptoms of leptospirosis (eg, fever, headache, nausea, vomiting) are often confused with viral illness.

In 10% of cases, the presentation is more dramatic, and the infection has an overall case fatality rate of 5%-10%. Known as Weil disease or icteric leptospirosis, the classic definition of this form of leptospirosis includes fever, jaundice, renal failure, and hemorrhage. Other organ systems (ie, pulmonary system, cardiac system, central nervous system) are also frequently involved. Risk factors associated with higher mortality risk include old age, alteration of mental status, and pulmonary alveolar hemorrhage. (See Clinical Presentation.)


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