Leptospirosis

  • Medical Author:
    Charles Patrick Davis, MD, PhD

    Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

  • Medical Editor: Mary D. Nettleman, MD, MS, MACP
    Mary D. Nettleman, MD, MS, MACP

    Mary D. Nettleman, MD, MS, MACP

    Mary D. Nettleman, MD, MS, MACP is the Chair of the Department of Medicine at Michigan State University. She is a graduate of Vanderbilt Medical School, and completed her residency in Internal Medicine and a fellowship in Infectious Diseases at Indiana University.

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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 (penicillin G, ampicillin [Omnipen, Polycillin, Principen], amoxicillin [Amoxil, Trimox, Moxatag, Larotid], or erythromycin [E-Mycin, Eryc, Ery-Tab, PCE, Pediazole, Ilosone]) are recommended for treatment of 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; however many choose to treat with doxycycline.

What is the prognosis of leptospirosis?

Overall, the prognosis of leptospirosis is good; many become infected and spontaneously recover without treatment. However, the prognosis worsens as the symptoms increase; people with Weil's disease may have a prognosis ranging from good to poor, depending on their response to treatment. 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 11/11/2015

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