Leptospirosis Explained

Leptospirosis Explained

In many cases, leptospirosis takes the course of a benign fever. Severe forms of the disease, however, can prove to be life-threatening.

What is leptospirosis?

The bacterium is usually transmitted to humans via body fluids (such as saliva, blood or urine) from infected rodents; in rarer cases transmission of leptospirosis by mammals is also possible. See AbbreviationFinder for abbreviations related to Leptospirosis.

Leptospirosis is an infectious disease caused by bacteria. Depending on the pathogen that caused leptospirosis in the person affected, different forms of the disease can be distinguished; Mention should be made here, for example, of Weil’s disease or field fever.

Typical symptoms of the first phase of a (usually two-phase) leptospirosis are similar to those of influenza : patients suffer from muscle pain and headaches as well as high fever. Other possible symptoms include skin rash or conjunctivitis. As part of a second phase of the disease, inflammation of the kidneys, liver and/or heart muscle can occur in addition to renewed fever.

The bacterial infectious disease is spread worldwide; Within Germany, around 40 people are affected by a new illness every year.


Leptospirosis is caused by infection with the bacterium Leptospira interrogans (a spiral-shaped bacterium belonging to the Leptospira genus). The bacterium is usually transmitted to humans via body fluids (such as saliva, blood or urine) from infected rodents; in rarer cases transmission of leptospirosis by mammals is also possible.

The liquids infected with the bacterium Leptospira interrogans get into the ground or water, for example. In the case of human contact with the corresponding substances, the leptospirosis-causing bacterium can penetrate the organism of a person concerned, for example via mucous membranes or skin injuries.

Infected droplets of secretion can also be ingested through the air we breathe, which can then lead to possible leptospirosis. Due to the way it is transmitted, workers in fields or sewers and water sports enthusiasts are particularly at risk of contracting leptospirosis.

Symptoms, Ailments & Signs

Leptospirosis can manifest itself through a wide variety of symptoms. Some people only feel a slight discomfort after being infected with the causative bacteria. In other cases, severe and, in extreme cases, even life-threatening complications can arise that require prompt treatment. The acute phase of the disease lasts about a week.

Due to the spread of the bacteria into the bloodstream, a fever develops in the first place, which can last three to eight days. This is sometimes accompanied by muscle pain, headaches and joint pain. Typical is the painful stiffening of the neck. In addition, conjunctivitis can develop, which manifests itself in noticeable swelling and reddening of the conjunctiva.

Heartbeat is reduced and blood pressure is low. A rash can also occur. In the immune phase, signs of the infestation of the internal organs can appear. Depending on which organ is affected, jaundice, coughing, shortness of breath or nephritis, for example, occur. If the course is severe, meningitis or heart muscle inflammation occurs after a few days. The severe symptoms appear in the second week of illness and quickly provoke a life-threatening condition.

Diagnosis & History

During the first phase of the disease, the causative agents of leptospirosis or antibodies formed can be detected, for example, by taking a blood sample. Since the bacterium Leptospira interrogans can often no longer be identified in the second phase of the disease, diagnosis here is usually based exclusively on the antibodies present in the organism of an affected person.

After a possible incubation period (the period between infection and the first symptoms of leptospirosis) of up to 30 days, the disease usually sets in suddenly; the first phase of the disease lasts about 3-7 days and is then replaced by a short, symptom-free time interval. The second phase of the disease that follows can last up to 30 days.

Mild forms of leptospirosis usually take a benign course. Field fever, for example, is one of the comparatively mild forms of the disease. The course of Weil’s disease is often more severe; here the disease can even lead to the death of a patient.


People with leptospirosis usually have the usual signs and symptoms of the flu or a cold. This leads to severe chills and a high fever. In most cases, patients also suffer from headaches and body aches. The patient’s resilience decreases significantly and the quality of life decreases.

Leptospirosis also often leads to conjunctivitis, which in the worst case can lead to complete blindness. Severe pain can also occur in the shins or calves. In the worst case, leptospirosis can lead to death if the internal organs are also damaged.

Treatment of this disease is carried out with the help of antibiotics and, as a rule, does not present any special complications. In most cases, the course of the disease is positive and there are no further symptoms. Other medications that can reduce fever are also used in the treatment. If the treatment is successful, there is no reduction in the patient’s life expectancy.

When should you go to the doctor?

If you notice an unusually high fever, chills, headaches, body aches and other symptoms that appear to be occurring without a cause, you should speak to your family doctor. There may be leptospirosis or another serious condition that requires investigation. If you develop gastrointestinal problems, coughing or a sore throat, you should also seek medical advice. Signs of jaundice indicate Weil’s disease. Liver dysfunction, pain in the right upper abdomen and blood clotting disorders also indicate an icteric course, which must be clarified by a doctor in any case.

Affected people should consult a doctor if the mentioned symptoms persist for more than a few days. If the symptoms suddenly get worse, you shouldn’t hesitate to see a doctor. The right contact person is the liver specialist. In addition, other internists and alternative physicians can be consulted, always depending on the type, severity and cause of the complaints. Patients with pre-existing conditions should speak to the doctor in charge if they have any unusual symptoms.

Treatment & Therapy

The type of medical treatment for leptospirosis depends, among other things, on the phase of the disease and individual symptoms.

During the first 5 days of an existing leptospirosis, the disease is usually treated with antibiotics ; Which antibiotic agents are used in individual cases depends, for example, on the assessment of the doctor treating you and the constitution of the patient.

If leptospirosis lasts longer than 5 days, antibiotic treatment usually has no effect. This is due to the fact that symptoms occurring in the second phase of leptospirosis are usually no longer due to the action of the causative bacterium; Rather, the corresponding symptoms are a consequence of the body’s own immune response to the bacterium Leptospira interrogans.

In the second phase of leptospirosis, sensible therapeutic measures therefore usually focus on combating individual symptoms: while high fever can be combated with antipyretic drugs, for example, other possible treatment measures are aimed at ensuring adequate fluid supply and repairing any damage to organs that may have occurred.

Outlook & Forecast

The prognosis of leptospirosis is linked to the time of diagnosis and the course of the disease. If left untreated, it becomes a life-threatening condition. The pathogens can spread unhindered in the organism and cause a weakening of the body. The internal organs are destroyed and ultimately the organism fails to function properly.

If a doctor’s visit is initiated as soon as the first symptoms appear, therapeutic measures can be initiated immediately. The administration of medication leads to a regression of the symptoms. The causative pathogen is prevented from spreading by the ingredients of the preparations and suddenly dies. If there is no damage to the organs, the prognosis is favorable and the patient can be discharged from therapy after a few weeks as recovered.

If treatment takes place at an advanced stage of the disease, the course of the disease worsens considerably. The activity of the internal organs is affected and in severe cases irreparable damage can occur. A fatal course of the disease is possible despite all efforts. For some patients, only an organ transplant can ultimately help to prolong life. There are numerous complications and challenges associated with this treatment measure. In addition, a stable immune system is essential for a transplant, as otherwise the donor organ will be rejected.


Leptospirosis can be prevented, for example, by avoiding staying in bodies of water that have not been declared harmless bathing areas by public authorities. Occupational leptospirosis can be counteracted primarily by wearing appropriate protective clothing. In order to avoid possible infection by pets, vaccination of appropriate animals is possible if there is a risk.


With a bacterial infection like leptospirosis, follow-up care is very important. On the one hand, the infection must be prevented from flaring up again and possibly leading to complications. An example is cardiac involvement after a cold. On the other hand, it is also about regenerating the body, which has been weakened by a bacterial infection, and in this way regenerating it and making it resilient again for the demands of everyday life.

The bacterial infection can affect different areas such as the respiratory tract and the gastrointestinal tract. Therefore, the aftercare measures are always somewhat different. However, strengthening the immune system is in almost all cases an important factor in follow-up care.

The defense against renewed bacterial infections and the strengthening of the general condition is possible with a whole bundle of measures. This includes a healthy diet with sufficient fluid intake, plenty of sleep and enough exercise. However, during activities and sports it is important that the patient no longer has a fever.

It is not uncommon for antibiotics to be prescribed against a bacterial infection, which can have side effects such as gastrointestinal problems or fungal infections. Follow-up care also means rebuilding the intestinal or vaginal flora in such infections. Nicotine and alcohol weaken the immune system. It is good if the patient does not take it during regeneration and aftercare Those affected should also visit a doctor regularly to check the medication and possible side effects and, in the event of intolerance, arrange for a change.

You can do that yourself

Once leptospirosis has been diagnosed, antibiotic therapy is required. Patients are advised rest and bed rest. Especially in the first few days after treatment, the immune system must be protected from greater stress, because a cold can lead to a superinfection, which would have serious consequences for the body. If the course is mild, the patient is allowed to return to light work and sports after a week.

If the course is severe, treatment in the clinic is required. Since leptospirosis does not necessarily remain an outpatient stay, appropriate precautionary measures must be taken for a longer stay in the hospital. After the treatment, you should take it easy again. The administration of cefotaxime, doxycycline and other antibiotics represents a considerable burden for the body and therefore requires good aftercare by the patient and doctor.

After the leptospirosis has subsided, further check-ups in the doctor’s office are indicated. In addition, the cause of the disease should be determined and the triggers avoided in the future. Pet owners who suspect an infection in their pet should consult a veterinarian and have the symptoms clarified before the disease spreads or even spreads to humans.