What is the pathogenesis of leptospirosis if left untreated?

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

If the host survives the acute infection, septicemia and multiplication of the organism persist until the development of opsonizing immunoglobulin in the plasma, followed by rapid immune clearance. Although the systemic immune response may eliminate the organism from the body, it may also lead to a symptomatic inflammatory reaction that can produce secondary end-organ injury.

Despite clearance from the blood, leptospires may remain in immunologically privileged sites, including the renal tubules, brain, and aqueous humor of the eye, for weeks to months. Persistent leptospires in the eye occasionally lead to chronic or recurrent uveitis. In humans, leptospires in the renal tubules and resulting leptospiruria rarely persist longer than 60 days.


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