Leptospirosis along with few question and answers

About leptospirosis

1. LEPTOSPIROSIS

2. CASE DISCUSSION A 40-year-old pineapple farmer from Vazhakulam , Ernakulam district, was admitted with signs of hepatorenal failure. On examination, he had high-grade fever, was icteric and his hands showed abrasions, which he said, were acquired while plucking pineapples. He gave a history of passing yellow urine since four days and also mentioned the presence of rodents in his farm. 1) What is your diagnosis? 2) Describe how his profession is a risk factor for acquiring this disease. 3) How will you investigate this case? 4) What is the treatment & prophylaxis? 5) What is Zoonosis? Name 2 Zoonotic infections

3. STAINED SMEAR

4. 1) What is your diagnosis? 2) Describe how his profession is a risk factor for acquiring this disease ANS 1. Leptospirosis (Weil’s disease)   ANS 2. Pineapple has thorns, which can cause abrasions in the farmer’s body while plucking them. Since the farm has rodents, it is possible for the farmer to be exposed to the urine of infected rodents mixed with water. Through the abrasions, Leptospira enters the body.

5. ANS 3 - Investigations: Specimens collected: Blood, Urine, CSF Microscopic demonstration of leptospires in blood or urine - By Dark field microscopy or silver impregnation staining. Molecular methods: PCR for detection of 16S or 23S rRNA gene Culture: EMJH medium, useful during the first few days of illness. 0.1-0.2 mL (1-5 drops) of blood, taken with aseptic precautions, are inoculated into each of 4-5 bottles containing approximately 5 mL - 10 mL of medium.

6. Animal Inoculation: Intraperitoneal inoculation of guinea pigs Serology: Antibody detection is by ELISA Immunochromatographic test (ICT) Microscopic agglutination test (MAT)

7. ANS 4. Treatment & prophylaxis: Treatment – Doxycycline 100mg bd for 7 days Chemoprophylaxis with doxycycline in case of exposure General measures Use of gloves, boots, covering of wounds, Rodent control measures avoidance of contaminated water. Vaccination has been tried in persons at high risk such as farmers, planters, etc.

8. ANS 5. Zoonoses is defined as infections that are naturally transmitted from vertebrate animals to humans.

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