Pathophysiology

Phase II (immune phase)

• CNS-dominant anicteric
• Respiratory-dominant anicteric
• Hepatic, or icteric (Weil's disease)

Diagnosis

Treatment

+ وياها fever بس نسيت اذكرها

I also forgot to mention: Leptospirosis can also cause petechial rash, purpura, and epistaxis.

This is due to endothelial dysfunction & resultant thrombocytopenia

وهاي كيسات عن الليبتو:

A 47-year-old health-care worker presents to the ER with 2 days of fever and dry cough. He returned home from a 2-week trip to Puerto Rico 6 days ago. In Puerto Rico, he volunteered to assist in recovery efforts following Hurricane Irma. He reports fever and myalgias a few days before returning home. He states that he felt fine for the last 3 days, but woke up this morning with fever and cough. He also noticed that he was jaundiced and had developed a petechial rash on his lower extremities. On physical examination, his vital signs show a temperature of 39 °C, heart rate of 123 beats per minute, respiratory rate of 20 breaths per minute, and blood pressure of 100/70. He is icteric, has an enlarged liver 3 cm below the right costal margin, and a fi ne petechial rash on both lower extremities. You suspect leptospirosis and have just ordered the appropriate diagnostic tests including a microscopic agglutination test (MAT), blood PCR test, and blood and urine cultures.
Results will not be available for several days. Of the following options, the best next steps in managing the patient include:


(a) Hospitalization, await definitive test results, provide aggressive supportive care
(b) Hospitalization, begin empiric intravenous benzylpenicillin, provide aggressive supportive care
(c) Request a chest radiograph, complete blood count, comprehensive metabolic panel, and coagulation studies, and advise the patient to return to the office the next day to review the test results
(d) Hospitalization, begin empiric oral amoxicillin, provide aggressive supportive care

A 29-year-old farmer from Barbados who is visiting family in Florida presents to your office with 3 days of fever, muscle pain in his calf, headache, and nausea.
He arrived in Florida 10 days ago. It is the rainy season in Barbados. The patient explains that his 19-year-old sister and 51-year-old father who are both in Barbados have similar symptoms. The family maintains a large farm that includes sheep, goats, and cows. During the patient’s physical examination, you observe an ocular finding that brings leptospirosis to the top of your differential diagnosis. What did you see?

(a) Anisocoria
(b) Uveitis
(c) Conjunctival suffusion
(d) Leptospira in the vitreous fluid

Answers:
1) B
Because we can't dx leptospirosis based on hx and physical exam alone, but also, the diagnostic tests take too long, that's why we start patients on empiric treatment before waiting for the confirmation of dx.
Btw, the patient's lungs are also involved, so a CXR would be a good investigation to check the extent of lung involvement.

2) C
This one's too easy