What is the pathogenesis 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

Urinary shedding of organisms from infected animals is the most important source of these bacterial pathogens. Contact with the organism via infected urine or urine-contaminated media results in human infection. Such media include contaminated water and food, as well as animal bedding, soil, mud, and aborted tissue. Under favorable conditions, leptospires can survive in fresh water for as many as 16 days and in soil for as many as 24 days. [17]

Leptospires are believed to enter the host through the following:

  • Abrasions in healthy skin

  • Animal and rodent bites

  • Sodden and waterlogged skin

  • Mucous membranes or conjunctiva

  • Lungs (after inhalation of aerosolized body fluid) [18]

  • The placenta during pregnancy

Virulent organisms in a susceptible host gain rapid access to the bloodstream through the lymphatics, resulting in leptospiremia and spread to all organs, but particularly the liver and kidney. The incubation period is usually 5-14 days but has been described from 72 hours to a month or more.


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