What are the signs and symptoms of acute phase leptospirosis?

Updated: Jul 08, 2021
  • Author: Sandra G Gompf, MD, FACP, FIDSA; Chief Editor: Michael Stuart Bronze, MD  more...
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An acute illness follows infection with any serovar of leptospirosis. Most of the following signs and symptoms may develop in varying degrees:

  • Headache

  • Fever (38-40°C)

  • Rigors

  • Muscle pain (typically localized to the calf and lumbar areas)

  • Nausea and vomiting

  • Anorexia

  • Diarrhea

  • Dry cough

  • Pharyngitis

  • Conjunctival suffusion

  • Nonpruritic skin rash

Despite reports of fever as a cardinal symptom, research by the Hawaii Department of Health found that the presence of fever varied. [25, 34] In serologically confirmed cases, 5% of patients gave no history of fever, and 55% were afebrile at the time of presentation. Myalgias and headache were universally reported at the time of presentation and were the chief complaint in 25% of patients.

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