Leptospirosis (cont.)

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How do physicians diagnose leptospirosis?

Physicians make a presumptive diagnosis based on the patient's history and physical exam. Only specialized labs perform serological tests for leptospirosis; health-care professionals may perform definitive tests by isolating the bacteria from the patient (blood or CSF) or by a positive microscopic agglutination test (MAT). Other tests (ELISA, PCR, urine dipsticks) may provide additional evidence of infection. Patients with severe symptoms should be treated as confirmatory tests are time consuming.

What is the treatment for leptospirosis?

Although there is controversy about using antibiotics in the first phase of leptospirosis, antibiotics are recommended for treatment (penicillin G, ampicillin [Omnipen, Polycillin, Principen], amoxicillin [Amoxil, Dispermox (Discontinued), Trimox, Moxatag, Larotid], or erythromycin [E-Mycin, Eryc, Ery-Tab, PCE, Pediazole, Ilosone]) in patients with phase two or more severe symptoms. Some patients may require IV antibiotics and supportive hospital care.

For those clinicians who choose to treat phase-one patients, the choice of antibiotics includes the above; many choose to treat with doxycycline, however.

What is the prognosis of leptospirosis?

Overall, the prognosis of leptospirosis is good; many become infected and spontaneously recover without treatment. However, the prognosis decreases as the symptoms increase; people with Weil's disease may have a prognosis ranging from good to poor, depending on their response to treatments. Pregnant women who become infected have a high rate of fetal mortality, especially if they acquire the disease early in pregnancy.

Medically Reviewed by a Doctor on 2/7/2014

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