Leptospirosis history and symptoms

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Venkata Sivakrishna Kumar Pulivarthi M.B.B.S [2]


Clinical symptoms of leptospirosis are very wide, with mild anicteric presentation at one end to severe leptospirosis with severe jaundice and multiple organ involvement. Classic presentation of leptospirosis is a biphasic illness and the onset of symptoms within 2–30 days (incubation period) of exposure to the bacteria. Serious symptoms may manifest earlier on Days 4–6 of the illness depending on the type of pathogen and host immunological status.[1]


In humans, Leptospirosis can cause a wide range of symptoms, including:[2][3]

Common Symtoms

Less Common Symptoms

Clinical Presentation

Acute phase Immune phase
  • It is also known as leptospiruric phase.
  • Circulating (IgM) antibodies are produced and leptospires are present in the urine
  • Characterestic findings that differentiate from other febrile illnesses are myalgia and conjunctival suffusion.[4]
  • Myalgia often involves in calf muscles and less commonly involves abdominal and paraspinal muscles.
Anicteric leptospirosis Icteric leptospirosis Severe leptospirosis
  • More common but serious illness is uncommon.
  • Most of cases present either sub-clinical or very mild severity.
  • Few cases present with a febrile illness of sudden onset.
  • Other symptoms include chills, headache (severe with retro-orbital pain and photophobia), myalgia, abdominal pain, conjunctival suffusion, and skin rash (transient and last <24 hours).
  • May progress to aseptic meningitis in ≤25% of patients and more common in younger age group than the patients with icteric leptospirosis.
  • Mortality is very less when compared to icteric leptospirosis.
  • Rapidly progressive and severe form of leptospirosis
  • Less common form of leptospirosis with incidence of 5%-10%.
  • Jaundice is not associate with hepatocellular injury, eventually LFT returns to normal after recovery.
  • High mortality rate with a range of 5%-15%.
Sever form of leptospirosis with organ failure including liver and kidney

involvement is known as Weil's disease.


  1. Faine, S (1982). Guidelines for the control of leptospirosis. Geneva Albany, N.Y: World Health Organization Obtainable from WHO Publication Centre USA. ISBN 924170067X.
  2. Heath CW, Alexander AD, Galton MM (1965). "Leptospirosis in the United States. Analysis of 483 cases in man, 1949, 1961". N Engl J Med. 273 (17): 915-22 concl. doi:10.1056/NEJM196510212731706. PMID 5319290.
  3. Perrocheau A, Perolat P (1997). "Epidemiology of leptospirosis in New Caledonia (South Pacific): a one-year survey". Eur J Epidemiol. 13 (2): 161–7. PMID 9084999.
  4. Forbes AE, Zochowski WJ, Dubrey SW, Sivaprakasam V (2012). "Leptospirosis and Weil's disease in the UK". QJM. 105 (12): 1151–62. doi:10.1093/qjmed/hcs145. PMID 22843698.