๐ ็ธฝ็ฎ้ ๏ฝ ๐ ่ฑๆๅๆ๏ผๆฌ็ฏ๏ผ ๏ฝ ๐ ๅฎๆด็ฟป่ญฏ ๏ฝ โญ ็ฒพ่ฏ็ญ่จ
LEPTOSPIROSIS
Synonyms:๏ก Fort Bragg fever ๏ก Pretibial fever ๏ก Weilโs disease
Leptospirosis is a worldwide zoonosis caused by spirochetes in the genus Leptospira. It is transmitted via contact of non-intact skin or mucous membranes with urine or other body fluids (with the exception of saliva) from infected mammals, either directly or from drinking or swimming in contaminated water. Veterinarians, farmers, slaughterhouse or sewer workers, and recreational water sport participants are most often affected. Leptospirosis occurs in an anicteric form (~90% of cases) and a more severe icteric form (~10% of cases). After an incubation period of 7โ12 days, an initial โsepticemicโ stage of fevers, chills, and myalgias lasting 3โ7 days is followed by an โimmuneโ stage (during which serologic tests are positive) that can result in meningitis, uveitis, and renal, hepatic, and/or pulmonary dysfunction. Cutaneous manifestations include erythematous macules, papules, patches, and/or plaques in a widespread distribution or (especially with L. interrogans serovar Autumnalis) localized to the shins, as well as petechiae and purpura secondary to vascular involvement. Although most cases are self-limited, antibiotics may decrease the duration of illness and reduce shedding of organisms in the urine. Oral doxycycline, amoxicillin, or azithromycin and (for more severe disease) intravenous penicillin or third-generation cephalosporins have been used.