Leptospira

Question 1

natural course of mild uncomplicated leptospirosis

Answer 1

spontaneous resolution within 7 –10 days without sequelae

Question 2

jaundice, acute kidney injury, hypotension, and hemorrhage—mostcommonly involving the lungs

Answer 2

Weil’s disease

Question 3

cardiac involvement in lep

Answer 3

nonspecific ST and T wave changes but also asright-bundle-branch block and right- and/or left-sided ventricular dilation indicating myocarditis

Question 4

gold std lepto

Answer 4

microscopic agglutination test (MAT)

Question 5

neuro findings lepto

Answer 5

aseptic meningitis

hypo- or areflexia, especially of the legs.

Question 6

primary renal pathophysiologic lesion in acute leptospirosis,

Answer 6

Primary injury of the proximal convoluted tubules

Question 7

diagnostic mainstay in leptospirosis.

Answer 7

Serologic assays

Question 8

Culture leptospira

Answer 8

blood and CSF during the first 7–10 days of illness and from urine beginning in the second week

Question 9

Rx mild leptospirosis

Answer 9

Doxycycline (100 mg PO bid) or Amoxicillin (500 mg PO tid) or Ampicillin (500 mg PO tid)

Question 10

Rx Moderate/severe leptospirosis

Answer 10

Penicillin (1.5 million units IV or IM q6h) or Ceftriaxone (1 g/d IV) or
Cefotaxime (1 g IV q6h)

Question 11

chemoprophylaxis

Answer 11

Doxycycline (200 mg PO once a week) or Azithromycin (250 mg PO once or twice a week)