http://www.scribd.

com/doc/48096998/pathophysiology-of-leptospirosis-and-denguefever Synonym: Weils Dse, Mud fever, Canicola fever, Flood fever, Swineherds Dse, Japanese Seven Days fever Definition & Background:

a bacterial zoonotic disease caused by spirochaetes of the genus Leptospira that affects humans and a wide range of animals, including mammals, birds, amphibians, and reptiles first described by Adolf Weil in 1886 when he reported an acute infectious disease with enlargement of spleen, jaundice and nephritis

Causative Agent:

Leptospira-genus bacteria was isolated in 1907 from post mortem renal tissue slice commonly found: Leptospira pyrogenes, Leptospira manilae, & other species like L. icterohemorrhagiae, L. canicola, L. batavia, L. Pomona, L. javinica in animals often is subclinical; an infected animal may appear healthy even as it sheds leptospires in its urine; humans are dead-end hosts for the leptospire

Predisposing Factors:

age: < 15 years of age sex: male season: rainy months geographic: prevalent in slum areas

Source of Infection Infection comes form contaminated food and water, and infected wild life and domestic animals especially rodents. 1. Rats ( L. leterohemoragiae) are the source of Weils disease frequently observed among miners, sewer, and abattoir workers. 2. Dogs (L. canicola) can also be the source of infection among veterinarians, breeders, and owners of dogs. 3. Mice (L. grippotyphosa) may alos be a source of infection that attacks farmers and flax workers. 4. Rats (L. bataviae) are the source of infection that attacks ricefield workers. Modes of Transmission Incubation Period:

6 15 days/ 2 8 weeks

Clinical Manifestations: 1st stage: Septicemic/ Leptospiremic Phase (4 7 days) - onset of high remittent fever, chills, headache, anorexia, nausea & vomiting, abdominal pain, joint pains, muscle pains, myalgia, severe prostration, cough, respiratory distress, bloody sputum. 2nd stage: Immune/ Toxic Phase (4 30 days) - if severe, death may occur between the 9th & 16th day 2 types:

Anicteric (without jaundice) return of fever of a lower degree with rash, conjunctival injection, headache, meningeal manifestations like disorientation, convulsions & signs of meningeal irritations (with CSF finding of aseptic meningitis) Icteric (with jaundice) Weil syndrome; hepatic & renal manifestations: hemorrhage, hepatomegaly, hyperbilirubinemia, oliguria, anuria with progressive renal failure; shock, coma & congestive heart failure in severe cases

3rd stage: Convalescence Phase - Relapses may occur during 4th or 5th week Diagnosis:

culture:

blood (1st week)

CSF (5th to 12th day) Urine (after 1st wk til pd of convalescence)

agglutination tests ( 2nd or 3rd week)

PATHOPHYSIOLOGY Complications:

pneumonia iridocyclitis, optic neuritis peripheral neuritis

Prognosis:

cause of death: renal & hepatic failure dse usually last 1 3 weeks but may be more prolonged; relapse may occur

Treatment:

specific measures: beneficial if done < 4 days of dse

Aqueous penicillin G (50,000 units/kg/day in 4-6 divided doses intravenously for 7-10 days Tetracycline (20-40 mg/kg/day in 4 doses); may not be given to children < 8 years old

general measures

symptomatic & supportice care administration of fluid, electrolytes & blood as indicated peritoneal dialysis (for renal failure)

Nursing Interventions:

isolation of patient: urine must be properly disposed health teachings: keep a clean environment

Nursing Care Plan Leptospirosis Related Nursing Articles 1. Nursing Care Plan LeptospirosisLeptospirosis is a bacterial disease that affects humans and animals. It is caused by bacteria of the genus Leptospira. In humans it causes a wide range of symptoms, and some infected persons may have no... 2. Leptospira IcterohaemorrhagiaeLeptospira Icteroheaemorrhagiae is a spirochete from the specie of Leptospira Interrogans. It is distributed worldwide like Leptospira canicola. Reservior hosts of this disease are mainly rats. Leptospira Icteroheaemorrhagiae is transmitted through contact with water contaminated... 3. Government to Employ More Nurses to Address Leptospirosis OutbreakAccording to DOH, the number of reported leptospirosis cases in Metro Manila and other areas in Luzon that were affected by floods has reached 1,027, with 89 fatalities as of October 15. Areas with declared... 4. Nursing Care Plan Hyperbilirubinemia (Jaundice)Hyperbilirubinemia (jaundice) in the neonate is an accumulation of serum bilirubin above normal levels. Onset of clinical jaundice is seen when serum bilirubin levels are 5 to 7 mg/100 dL. Physiologic jaundice occurs 3 to... 5. Cold or Flu: How to Tell the DifferenceAre you sneezing a lot with cough and have that achy and feeling that you seem dont want to move? If so, you might be having cold or flu? More often people use the terms...
What are leptospirosis symptoms and signs?

Leptospirosis symptoms begin from two to 25 days after initial direct exposure to the urine or tissue of an infected animal. This can even occur via contaminated soil or water. Veterinarians, pet shop owners, sewage workers, and farm employees are at particularly high risk. People participating in outdoor sporting activities like canoeing, rafting, hiking, and camping can also come into contact with contaminated water or soil. The illness typically progresses through two phases:

The first phase of nonspecific flu-like symptoms includes headaches, muscle aches, eye pain with bright lights, followed by chills and fever. Watering and redness of the eyes occurs and symptoms seem to improve by the fifth to ninth day. The second phase begins after a few days of feeling well. The initial symptoms recur with fever and aching with stiffness of the neck. Some patients develop serious inflammation of the nerves to the eyes, brain, spinal column (meningitis), or other nerves. Right upper area abdominal pain may occur. Less common symptoms relate to disease of the liver, lungs, kidneys, and heart.

Leptospirosis associated with liver and kidney disease is called Weil's syndrome and is characterized by yellowing of the eyes (jaundice). Patients with Weil's syndrome can also develop kidney disease and have more serious involvement of the organs affected. jaundice occurs when there is:
1. too much bilirubin being produced for the liver to remove from the blood (for example, patients with hemolytic anemia have an abnormally rapid rate of destruction of their red blood cells that releases large amounts of bilirubin into the blood); 2. a defect in the liver that prevents bilirubin from being removed from the blood, converted to bilirubin/glucuronic acid (conjugated) or secreted in bile; or 3. blockage of the bile ducts that decreases the flow of bile and bilirubin from the liver into the intestines. For example, the bile ducts can be blocked by cancer, gallstones, or inflammation of the bile ducts. The decreased conjugation, secretion, or flow of bile that can result in jaundice is referred to as cholestasis: however, cholestasis does not always result in jaundice.

A risk factor is something that increases your chance of getting a disease or condition. Anyone can contract leptospirosis, but the following people are at an increased risk of developing leptospirosis:

Canoeists Rafters Swimmers (in lakes, rivers, and streams) Workers in flood plains Workers in wet agricultural settings People who have pets, particularly dogs or livestock People who work with the land, including farmers, ranchers, loggers, and rice-field workers People who work with animals, including veterinarians

http://www.scribd.com/doc/34683991/Pathognomonic-Signs-of-Diseases Pathognomonic is a sign or symptom that is so characteristic of a disease that it makes the diagnosis. Pathognomonic (pronounced patho-no-monic) comes from the Greek pathognomonikos meaning skilled in judging diseases. As it is very important to know how to assess characteristic manifestations of some communicable diseases at an early stage, here are the pathognomonic signs and symptoms of some common communicable diseases.

AIDS opportunistic and malignant manifestations, T4 below 200/dl. (Opportunistic infection - infection that occurs because of a weakened immune system. Opportunistic infections are a particular danger for people with AIDS. The HIV virus itself does not cause death, but the opportunistic infections that occur because of its effect on the immune system can.) Amoebiasis bloody mucoid stool. Ascariasis vomiting, passing out of worm. Candidiasis cheeselike discharge. Chicken pox vesiculopopular lesions. Cholera rice-watery stool. Dengue/Hemorrhagic Fever Hermans sign. It appears on the upper and lower extremities, purplish or violaceous red with blanched areas about 1 cm or less in size. Diptheria pseudomembrane, a localized inflammatory process; Grayish-white, leathery consistency. Enterobiasis nocturnal itchiness. Filariasis - Elephantiasis. German Measles/Rubella Forscheimers spots, a mild enanthem of petechial lesions. Gonorrhea thick purulent discharge. Herpes Zoster lesions follow peripheral nerve pathway. Leptospirosis orange eyes. Malaria fever and chills. Measles/Rubeola Kopliks spots, little spots inside the mouth. The spots look like a tiny grains of white sand, each surrounded by a red ring. They are found especially on the inside of the cheek (the buccal mucosa) opposite the 1st and 2nd upper molars. Meningitis nucchal rigidity. Mumps swollen parotid glands. Pertussis paroxysmal coughs ending with whoop. Pneumonia rusty sputum. Polio flaccid paralysis, weakness or paralysis and reduced muscle tone without other obvious cause (e.g., trauma). Rabies hydrophobia, a morbid fear of water. Because of this name, many people think that rabies makes one afraid of water. In fact, this is not the case (although rabies does cause mental confusion of other kinds). The name hydrophobia comes from the fact that animals and people with rabies get spasms in their throat muscles that are so painful that they cannot eat or drink, and so will refuse water in spite of being very thirsty. Scabies weeping itch.

Scarlet Fever raspberry tongue. Syphilis painless chancre or ulceration. Tetanus locked jaw or trismus. Tuberculosis initially ASYMPTOMATIC. Typhoid Fever 3 cardinal signs: ladderlike fever, rose spots, spleenomegaly (enlargement of spleen beyond its normal size).

http://www.rightdiagnosis.com/l/leptospirosis/symptoms.htm