How is leptospirosis treated?

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

Treatment of leptospirosis should be started as soon as possible. Treatment is begun empirically in patients with a plausible exposure history and compatible symptoms, as culture times for Leptospira are long and recovery rates are low. The criterion standard for serologic identification of leptospires, microscopic agglutination testing (MAT), is available only at reference laboratories. Paired acute and convalescent serum specimens can provide delayed confirmation of the diagnosis.

In uncomplicated infections that do not require hospitalization, oral doxycycline has been shown to decrease duration of fever and most symptoms. In hospitalized patients, intravenous penicillin G has been the treatment of choice. Patients with severe leptospirosis (Weil disease) require supportive therapy and careful management of renal, hepatic, hematologic, and central nervous system complications. (See Treatment.)


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