leptospirosis

1. RSUD LEMBANG DWI PUTRA SORE KLINIK
Weil’s Disease
More Than Leptosirosis
6 FEB 2023

2. • Leptospirosis is a zoonotic bacterial disease.
• caused by Leptospira interrogans
• rat-borne transmission
• cause of pulmonary haemorrhage syndrome
• acute kidney injury due to Weil’s disease
Often misdiagnose as Malaria, Dengue,
other causes of an acute febrile illness
Epidemiologi
Facts
Definsi
• Adolph Weil first described leptospirosis in 1886 as a febrile
illness with icterus, enlarged spleen, renal failure and
conjunctivitis associated with outdoor occupations where
people came into contact with water.
• Weil’s disease is severe leptospirosis
Costa, F., Hagan, J. E., Calcagno, J., Kane, M., Torgerson, P., Martinez-Silveira, M. S., Stein, C., Abela-Ridder, B., & Ko, A. I. (2015). Global Morbidity and Mortality of
Leptospirosis: A Systematic Review. PLoS Neglected Tropical Diseases, 9(9). https://doi.org/10.1371/journal.pntd.0003898
• Tropical Area, poor sanitation, farming area, urban
area
• Incidences South-East Asia 55.54 100.000 population ,
(20.32– 99.53
• Mortality South –East Asia 2.96 per 100.000
population (1.65–4.93)
The commonest means of transmission to humans is through
abrasions on the skin and mucous membranes coming into
contact with water contaminated with infected rat urine

3. ANAMNESIS
• A Non-specific Acute Febrile
Illness For 3 To 9 Days
• Fever (96.5%)
• Jaundice (94.5%)
• Myalgia (92.5%)
• Headache (74.6%)
• Vomiting (71.6%)
• Dehydratation (63.5%)
• Chills (62.2%)
• Hemorrhagic manifestations
(35.8%)
Daher, E. F., Lima, R. S. A., Silva Júnior, G. B., Silva, E. C., Karbage, N. N. N., Kataoka, R. S., Carvalho Júnior, P. C., Magalhães, M. M., Mota, R. M. S., & Libório, A. B. (2010). Clinical
presentation of leptospirosis: A retrospective study of 201 patients in a metropolitan city of Brazil. Brazilian Journal of Infectious Diseases, 14(1), 3–10. https://doi.org/10.1016/S1413-
8670(10)70002-7
Rajapakse, S. (2022). Leptospirosis: Clinical aspects. In Clinical Medicine, Journal of the Royal College of Physicians of London (Vol. 22, Issue 1, pp. 14–17). Royal College of Physicians.
https://doi.org/10.7861/clinmed.2021-0784

4. Manifestasi Klinis
Sukma, F. A., Mulida, M., & Sujana, K. S. (2021). LAPORAN
KASUS Severe Leptospirosis (CKD-298 Vol. 48, Issue 11).
Leptospirosis
Anikterik •Demam
•Mialgia
•Conjunctival
Suffusion
•Nyeri Kepala
•Ginjal : Proteinuria
ringan
•Perdarahan
Leptospirosis
Ikterik
•Hepatic : Jaundice
•Gangguan Ginjal
•Trombositopeni
•Gejala Paru :
Pulmonary
Heamorrhage
•Gejala Kardio : Syok
•Gejala SSP
•Erupsi Kulit

5. Pathophysiology
Samrot, A. v., Sean, T. C., Bhavya, K. S., Sahithya, C. S., Chandrasekaran, S., Palanisamy, R., Robinson, E. R., Subbiah, S. K., & Mok,
P. L. (2021). Leptospiral infection, pathogenesis and its diagnosis—a review. In Pathogens (Vol. 10, Issue 2, pp. 1–30). MDPI AG.
https://doi.org/10.3390/pathogens10020145

6. Laboratory Findings
Daher, E. F., Lima, R. S. A., Silva Júnior, G. B., Silva, E. C., Karbage, N. N. N., Kataoka, R. S., Carvalho Júnior, P. C., Magalhães, M. M., Mota, R. M. S., & Libório, A. B. (2010). Clinical
presentation of leptospirosis: A retrospective study of 201 patients in a metropolitan city of Brazil. Brazilian Journal of Infectious Diseases, 14(1), 3–10.
https://doi.org/10.1016/S1413-8670(10)70002-7

7. Diagnostic Test for Leptospira
Rajapakse, S. (2022). Leptospirosis: Clinical aspects. In Clinical Medicine, Journal of the
Royal College of Physicians of London (Vol. 22, Issue 1, pp. 14–17). Royal College of
Physicians. https://doi.org/10.7861/clinmed.2021-0784

8. Scoring Faine
Berdasarkan kriteria Faine yang dimodifikasi (Tabel 1)
Diagnosis presumtif leptospirosis dapat ditegakkan jika:
a) Skor bagian A atau bagian A + bagian B > 26 atau
b) Skor bagian A + bagian B + bagian C > 25.
c) Skor antara 20 dan 25 menunjukkan kemungkinan diagnosis
leptospirosis tetapi belum terkonfirmasi
Sukma, F. A., Mulida, M., & Sujana, K. S. (2021). LAPORAN KASUS
Severe Leptospirosis (CKD-298 Vol. 48, Issue 11).

9. Therapies
Sukma, F. A., Mulida, M., & Sujana, K. S. (2021). LAPORAN KASUS Severe Leptospirosis (CKD-298 Vol. 48, Issue 11).

10. Hatur Nuhun