Answer 94
Leptospirosis:
True a. usually causes a self-limiting disease
False b. is caused by Gram positive bacilli
False c causes leucopaenia
True d. causes jaundice
True e. causes meningitis
Leptospirosis is caused by Leptospira species which are Gram negative spirochaetes. Rodents are the usual reservoir but larger animals may also carry and excrete the organism.
Presentation is with fever, myalgia, headache, conjunctival injection and hepatomegaly. Jaundice occurs in 10-20% of cases and is usually cholestatic.
Meningitis may occur. The CSF shows a mixture of lymphocytes and polymorphs, and the CSF sugar is often normal.
Complications include renal failure, pneumonitis and DIC.
Diagnosis is suggested by an appropriate exposure history and is usually
confirmed subsequently by serology. Doxycycline or penicillin are appropriate antibiotic treatments.
