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Incubation period 7-14 days. Then sudden onset of headache and limb pain (often calf pain, myalgia), conjunctivitis (typical, meningismus and fleeting exanthema. Strong feeling of illness, fever and drowsiness for 5-10 days. After short-term defibrillation, organ manifestations with renewed fever, leptospiruria (> 90% of patients), jaundice , haemorrhagic diathesis, anaemia, involvement of internal organs, meningitis.
Significantly more frequently than the severely pronounced symptoms, anikteric, mostly benign courses of disease were described. Serous meningitis (30-40% of patients) is often the main symptom. Patients with uncomplicated courses of the disease develop fever after 7-10 days.
Severe courses of the disease with high mortality occur mainly in people over 50 years of age.
Untreated, the symptoms of the disease can last 3-4 weeks, but convalescence often lasts several months.
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Severe cases: Early antibiotic therapy with penicillin G in high dosage (starting within the first 48 hours). Thereafter, manifestation of leptospires in the internal organs without access to therapy. Penicillin G/ Benzylpenicillin: 10-20 million IU/day i.v. over 7-14 days. Cave! Risk of Herxheimer's reaction. Prophylaxis of the Herxheimer's reaction with prednisolone 40-60 mg/day for 10-14 days, gradual dosing.
Lighter cases: Tetracyclines (e.g. Achromycin) (only bacteriostatic effect): Adults 3-4 times/day 0.5-1.0 g p.o. Cave! Already existing liver or kidney damage is considered as contraindication.
In case of organ manifestations try haemodialysis.
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- Abdulkader RC et al (2002) Leptospirosis severity may be associated with the intensity of humoral immune response. Rev Inst Med Trop Sao Paulo 44: 79-83
- Akiyama K et al (2001) A fatal case of Weil's disease in Miyagi Prefecture. Jpn J Infect Dis 54: 156-157
- Landouzy LTJ (1883) Typhoid fever hépatique. Gaz hôp (Paris) 56: 913-914
- Mathieu A (1886) Typhoid hépatique benin; rechute, guérison. Revue médicale (Paris) 6: 833-639
- Because A (1886) About a peculiar acute infectious disease associated with spleen tumor, icterus and nephritis. Dtsch Arch klin Med (Leipzig) 39: 209-232
- Wenz M et al (2001) Weil's syndrome with bone marrow involvement after collecting walnuts. German Med Weekly 126: 1132-1135
- Yiu MW et al (2003) High resolution CT of Weil's disease. Lancet 362: 117
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Incoming links (5)
Kawasaki syndrome; Leptospirosis icterohaemorrhagica; Renal diseases skin changes; Weil's disease; Zika fever;Outgoing links (10)
Conjunctivitis; Elisa; Herxheimer reaction; Icterus; Obligation to notify; Penicillin g; Prednisolone; Protection against infection law; Rash; Tetracyclines;Disclaimer
Please ask your physician for a reliable diagnosis. This website is only meant as a reference.
Prof. Dr. med. Peter Altmeyer