Leptospirosis is a widely recognized infection caused by a spirochetal bacteria, Leptospira spp., and virtually any region of the world is considered to be endemic for this infection [1] [2] [3] [4]. These microbial organisms are responsible for chronic renal infections in a range of animal hosts (livestock, medium-sized mammals, rodents, bats, amphibians and various other), who excrete them through urine and contaminate soil, water or even food, which are the primary sources of human exposure [1] [2] [5]. After the acquisition of Leptospira through abraded or damaged skin/mucosal membranes when in contact with contaminated water or soil, the mean incubation period is about 7-14 days (ranging from 2-30 days) [2] [4] [5] [6]. Although the clinical presentation can be quite variable, fever accompanied by chills, myalgia, headaches, meningismus, a nonproductive cough and gastrointestinal complaints (diarrhea, nausea, vomiting and abdominal pain) are seen in the majority of cases [2] [3] [6] [7]. In approximately 10% of patients, a severe form of leptospirosis develops and the term Weil's disease is used to describe the life-threatening organ dysfunction that is encountered, primarily involving the liver and the kidneys [2] [3] [4] [5]. Acute kidney injury (AKI) manifesting as oliguria, or even anuria in the setting of renal failure, together with jaundice, are hallmarks of Weil's disease [2] [4] [5] [6]. In addition, thrombocytopenia and several other factors contribute to hemorrhagic episodes, most frequently in the pulmonary system (presenting as hemoptysis), whereas epistaxis, petechiae, ecchymoses, melena or hematemesis can also develop [2]. Multiorgan failure, acute respiratory distress syndrome (ARDS), circulatory collapse and altered consciousness may all ensue in Weil's disease, which is why mortality rates reach up to 30%, especially in the absence of early recognition and proper therapy [3] [6]. Moreover, older patients and those who suffer from loss of consciousness are at a significantly higher risk for fatal outcomes [2] [3].

• Fever

  Wikipedia: Leptospirosis | Weil's syndrome | canicola fever | canefield fever | nanukayami fever | 7-day fever | Rat Catcher's Yellows | Fort Bragg fever | black jaundice | ... caused by infection with bacteria of the genus Leptospira and affects humans [memidex.com]

  As fever still remained and was followed by jaundice, decreasing hemoglobin, increasing bilirubin with abnormal value of liver enzymes; other causes of disease were investigated. [ncbi.nlm.nih.gov]

  Case Report A 69-year-old male agricultural laborer was admitted with a history of fever since 2 weeks and decreased urine output since 1-week. [jdrntruhs.org]

  Fever, constitutional symptoms, gastrointestinal irritation and muscle ache progressing to hepatorenal failure, pulmonary dysfunction, and involvement of other organs is the typical clinical presentation. [symptoma.com]

• Chills

  \ ˈvī(ə)lz-, ˈwī(ə)lz- \ Medical Definition of Weil's disease : a severe form of leptospirosis that is characterized by jaundice, chills, fever, muscle pain, shortness of breath, and chest pain and that is caused by a spirochete of the genus Leptospira [merriam-webster.com]

  Technical Information for Leptospirosis Clinical Features Symptoms of leptospirosis include fever, headache, chills, muscle aches, vomiting/diarrhea, cough, conjunctival suffusion, jaundice, and sometimes a rash. [web.archive.org]

  Although the clinical presentation can be quite variable, fever accompanied by chills, myalgia, headaches, meningismus, a nonproductive cough and gastrointestinal complaints (diarrhea, nausea, vomiting and abdominal pain) are seen in the majority of cases [symptoma.com]

• Fatigue

  Director’s Briefing Fatigue is common amongst the population, but particularly among those working abnormal hours, and can arise from excessive working time or poorly designed shift patterns. [shponline.co.uk]

  CRITICAL PLANE METHOD FOR MULTIAXIAL FATIGUE LIFE ASSESSMENT OF COMPONENTS UNDER COMBINED BENDING-TORSION LOADING International Journal of Fracture Fatigue and Wear. 3, 90-96 JIAWA LU, W. SUN, A.A. BECKER and ABDULLAH AZIZ SAAD, 2015. [nottingham.ac.uk]

  "The extreme and continued muscle and joint pain and the fact he is still extremely fatigued and feverish show all the classic signs of Weil's. He is undergoing tests but at least he's in good hands." [independent.ie]

  After an incubation period that can vary from three days to three weeks, most patients suffer severe headaches, red eyes, muscle pains, fatigue, nausea and a temperature of 39C or above. [theguardian.com]

  Sensitivity to light, chills, muscle pain, fatigue and vomiting are also common features of the infection. Due to the likeness, Leptospirosis could be easily dismissed as something less threatening. [devshp.ubmemea.webfactional.com]

• High Fever

  Symptoms Symptoms begin between 3 and 21 days after exposure, with an influenza-like illness with severe headache, high fever, tiredness, chills, muscle aches and vomiting. [hnbc.org.uk]

  Mild (anicteric) leptospirosis Clinical manifestations during the early phase are due to bacteremia High fever, headache Diarrhea, vomiting[1][2] Conjunctivitis Rash Myalgias (especially in the calves and lower back) Most cases of mild leptospirosis resolve [amboss.com]

  Symptoms: high fever, severe headache, chills, muscle aches, and vomiting. Also may include jaundice, red eyes, abdominal pain, diarrhea, or a rash. [web.archive.org]

  A high index of suspicion is needed in endemic areas, and leptospirosis must be considered when a patient presents with acute onset of fever, headache and myalgia. [jdrntruhs.org]

• Anemia

  mild to moderate anemia, and thrombocytopenia.[4] The anemia frequently observed in Weil's syndrome has been ascribed on clinical impression to blood loss, renal failure, and/or an ill-defined hemolytic process. [jdrntruhs.org]

  Severe Weil's syndrome complicated by hemolytic anemia. Int J Infect Dis 2010; 14:e181-2. http://dx.doi.org/10.1016/j.ijid.2009.03.032 6. Baytur YB, Lacin S, Koyuncu FM, et al. Weil's syndrome in pregnancy. [doi.org]

• Cough

  Other symptoms may include: conjunctivitis, vomiting, diarrhea, stomach pain, jaundice, cough, and rarely a skin rash. [web.archive.org]

  Although the clinical presentation can be quite variable, fever accompanied by chills, myalgia, headaches, meningismus, a nonproductive cough and gastrointestinal complaints (diarrhea, nausea, vomiting and abdominal pain) are seen in the majority of cases [symptoma.com]

  Prostration, coughing, expectoration of blood-stained sputum (hemoptysis), and nosebleed (epistaxis) may also occur. Yellowing of the skin (jaundice), bleeding in muscles, gastrointestinal tract, and visceral organs may be widespread. [rarediseases.org]

• Hemoptysis

  Pericorneal reddening, Photophobia Iridocyclitis Retro orbital pain, Rash O looks like a heart for bradycardia Weil's disease mnemonic "WEILS" Wet due to hemorrhage E is to remind me of epistaxis and other hemorrhagic manifestations like petechiae, hemoptysis [medicowesome.com]

  Desmopressin therapy for massive hemoptysis associated with severe leptospirosis. Am J Respir Crit Care Med. 2003;167:726-28. Kishor KK, Rao PV, Bhat KR, et al. Pancreatitis in Weil’s disease. Trop Doct. 2002;32:230-31. [rarediseases.org]

  In addition, thrombocytopenia and several other factors contribute to hemorrhagic episodes, most frequently in the pulmonary system (presenting as hemoptysis), whereas epistaxis, petechiae, ecchymoses, melena or hematemesis can also develop. [symptoma.com]

• Vomiting

  Other symptoms may include: conjunctivitis, vomiting, diarrhea, stomach pain, jaundice, cough, and rarely a skin rash. [web.archive.org]

  Signs included vomiting in 9 patients, haemorrhages in 6, and renal function was impaired in 6. Creatine phosphokinase levels were found above normal limits in 75% of the cases. [ncbi.nlm.nih.gov]

  Although the clinical presentation can be quite variable, fever accompanied by chills, myalgia, headaches, meningismus, a nonproductive cough and gastrointestinal complaints (diarrhea, nausea, vomiting and abdominal pain) are seen in the majority of cases [symptoma.com]

• Nausea

  Although the clinical presentation can be quite variable, fever accompanied by chills, myalgia, headaches, meningismus, a nonproductive cough and gastrointestinal complaints (diarrhea, nausea, vomiting and abdominal pain) are seen in the majority of cases [symptoma.com]

  Symptoms: Diarrhea, vomiting, headaches, fever, cramps, nausea. What: Think Montezuma’s revenge that’s not the result of tasty, yet sketchy, street tacos. [web.archive.org]

  After an incubation period that can vary from three days to three weeks, most patients suffer severe headaches, red eyes, muscle pains, fatigue, nausea and a temperature of 39C or above. [theguardian.com]

  Infection with the bacterium causes an illness which has similar symptoms to flu – temperature, muscle aches and nausea. In mild cases these symptoms can be easily treated and patients will likely recover in a few weeks. [rya.org.uk]

• Abdominal Pain

  Although the clinical presentation can be quite variable, fever accompanied by chills, myalgia, headaches, meningismus, a nonproductive cough and gastrointestinal complaints (diarrhea, nausea, vomiting and abdominal pain) are seen in the majority of cases [symptoma.com]

  Also may include jaundice, red eyes, abdominal pain, diarrhea, or a rash. If the disease is not treated, the patient could develop kidney damage, meningitis, liver failure, and respiratory distress. In rare cases death occurs. [web.archive.org]

  Later symptoms may include jaundice, eye redness, abdominal pain and diarrhoea. Severe cases can cause failure of kidneys or liver. The disease can be fatal – do not ignore symptoms. [hnbc.org.uk]

  Case 3-2020: A 44-Year-Old Man with Weight Loss, Diarrhea, and Abdominal Pain. N Engl J Med. 2020 Jan 23; 382(4):365-374. PMID: 31971683. Citations: Weil AA, Becker RL, Harris JB. [connects.catalyst.harvard.edu]

• Jaundice

  Severe leptospirosis characterised by profound jaundice is referred to as Weil's disease. [ncbi.nlm.nih.gov]

  Jaundice in experimental leptospirosis in guinea pigs. Can J Comp Med 1977;41:182-7. [Figure 1] [jdrntruhs.org]

  (L. interrogans, especially serotype icterohaemorrhagiae) Note: If left untreated, Weil's disease may cause life-threatening damage to the brain, kidneys, lungs, liver, or heart. — called also leptospiral jaundice, Weil's syndrome [merriam-webster.com]

  About 10 to 15% of patients with Weil's disease become severely ill with: a 'flu-like illness, followed by, jaundice haemorrhage renal impairment The majority suffer a benign self-limiting illness without jaundice. [gpnotebook.co.uk]

  Weil Syndrome Synonyms of Weil Syndrome Fiedler Disease Icteric Leptospirosis Icterohemorrhagic Leptospirosis Infectious Jaundice Lancereaux-Mathieu-Weil Spirochetosis Leptospiral Jaundice Spirochetal Jaundice Weil Disease General Discussion Weil syndrome [rarediseases.org]

• Hepatomegaly

  Only 10% of patients with mild leptospirosis progress to the severe form (Weil's disease).[3] Severe leptospirosis (Weil disease, icterohemorrhagic leptospirosis) Clinical features are due to systemic spread and multiorgan involvement Hepatitis; → hepatomegaly [amboss.com]

  Weil syndrome is characterized by dysfunction of the kidneys and liver, abnormal enlargement of the liver (hepatomegaly), persistent yellowing of the skin, mucous membranes, and whites of the eyes (jaundice), and/or alterations in consciousness. [rarediseases.org]

• Petechiae

  […] conjunctival) Pericorneal reddening, Photophobia Iridocyclitis Retro orbital pain, Rash O looks like a heart for bradycardia Weil's disease mnemonic "WEILS" Wet due to hemorrhage E is to remind me of epistaxis and other hemorrhagic manifestations like petechiae [medicowesome.com]

  In addition, thrombocytopenia and several other factors contribute to hemorrhagic episodes, most frequently in the pulmonary system (presenting as hemoptysis), whereas epistaxis, petechiae, ecchymoses, melena or hematemesis can also develop. [symptoma.com]

  The disease is characterized by jaundice, fever, oliguria, headache, myalgia, haemorrhagic tendencies with purpura or petechiae, and enlargement of liver and spleen. The illness lasts from 4 to 9 days. [whonamedit.com]

• Purpura

  The disease is characterized by jaundice, fever, oliguria, headache, myalgia, haemorrhagic tendencies with purpura or petechiae, and enlargement of liver and spleen. The illness lasts from 4 to 9 days. [whonamedit.com]

  Haug Browse recently published Learning/CME Learning/CME View all learning/CME CME Case 3-2019: A 70-Year-Old Woman with Fever, Headache, and Progressive Encephalopathy Caplacizumab Treatment for Acquired Thrombotic Thrombocytopenic Purpura Randomized [nejm.org]

  Hemorrhage can occur as petechiae, purpura, conjunctival hemorrhage and gastrointestinal hemorrhage. MOF is associated with a very high mortality. [jdrntruhs.org]

• Myalgia

  The most common presentation involved fever, malaise and myalgia. Conjunctival congestion was found in 75% of the cases and jaundice was encountered in 90% of the cases. [ncbi.nlm.nih.gov]

• Epistaxis

  […] through animal urine Occipital headache Suffusion (conjunctival) Pericorneal reddening, Photophobia Iridocyclitis Retro orbital pain, Rash O looks like a heart for bradycardia Weil's disease mnemonic "WEILS" Wet due to hemorrhage E is to remind me of epistaxis [medicowesome.com]

  The patients with thrombocytopenia had higher frequencies of dehydration (53% vs. 35.3%, p=0.001), epistaxis (5.7% vs. 0.8%, p=0.033), hematemesis (13% vs. 4.6%, p=0.006), myalgia (91.5% vs. 84.5%, p=0.038), hematuria (54.8% vs. 37.6%, p=0.011), metabolic [ncbi.nlm.nih.gov]

  In addition, thrombocytopenia and several other factors contribute to hemorrhagic episodes, most frequently in the pulmonary system (presenting as hemoptysis), whereas epistaxis, petechiae, ecchymoses, melena or hematemesis can also develop. [symptoma.com]

  Prostration, coughing, expectoration of blood-stained sputum (hemoptysis), and nosebleed (epistaxis) may also occur. Yellowing of the skin (jaundice), bleeding in muscles, gastrointestinal tract, and visceral organs may be widespread. [rarediseases.org]

• Hematuria

  During the first 6 days of this undiagnosed illness azotemia increased, a pericardial friction rub occurred, and hematuria was present. [ncbi.nlm.nih.gov]

  […] findings for leptospirosis and Weil's disease are leukocytosis, thrombocytopenia, elevated blood urea nitrogen (BUN), creatinine, and liver transaminases (alanine and aspartate aminotransferases, or ALT and AST), hyperbilirubinemia, proteinuria, pyuria, hematuria [symptoma.com]

  […] icterohemorrhagic leptospirosis) Clinical features are due to systemic spread and multiorgan involvement Hepatitis; → hepatomegaly, jaundice, acute liver failure Hemorrhagic diathesis Acute kidney injury (interstitial nephritis, acute tubular necrosis) → oliguria, hematuria [amboss.com]

• Kidney Failure

  Sometimes the fever may fluctuate and other symptoms such as a rash, jaundice, confusion, depression, kidney failure, liver failure and meningitis may occur. The incubation period is usually 10 days but can range from 4 to 19 days. [hellandback.ie]

  There is significant and rapid organ damage: liver and kidney failure can occur within 10 days, leading to jaundice (these are the only cases that can properly be called Weil's disease). [theguardian.com]

  Symptoms can range from none at all to a mild flu-like illness, or a more severe illness called Weil's disease, with jaundice and kidney failure. In most cases, with antibiotic treatment, the person will make a complete recovery. [bbc.com]

• Oliguria

  Clinical trials included for meta-analysis were compared on the basis of mortality, fever days, numbers of patients presenting with oliguria, and number of patients undergoing need-based dialysis. [ncbi.nlm.nih.gov]

  Acute kidney injury (AKI) manifesting as oliguria, or even anuria in the setting of renal failure, together with jaundice, are hallmarks of Weil's disease. [symptoma.com]

  The disease is characterized by jaundice, fever, oliguria, headache, myalgia, haemorrhagic tendencies with purpura or petechiae, and enlargement of liver and spleen. The illness lasts from 4 to 9 days. [whonamedit.com]

• Renal Insufficiency

  We report the first case to our knowledge of leptospirosis in a liver transplant recipient who developed jaundice and renal insufficiency. [doi.org]

  In icteric leptospirosis (Weil's syndrome), persistent high fever and jaundice are usually associated with hepatic dysfunction, renal insufficiency, hemorrhage and multi-organ failure (MOF). [jdrntruhs.org]

• Headache

  Technical Information for Leptospirosis Clinical Features Symptoms of leptospirosis include fever, headache, chills, muscle aches, vomiting/diarrhea, cough, conjunctival suffusion, jaundice, and sometimes a rash. [web.archive.org]

  Mnemonic for leptospirosis "LEPTOSPIRO " Lymphadenopathy Encephalitis (And meningitis) Pain in abdomen Transmitted through animal urine Occipital headache Suffusion (conjunctival) Pericorneal reddening, Photophobia Iridocyclitis Retro orbital pain, Rash [medicowesome.com]

  The early phase of the disease is mild and characterized by non-specific symptoms (e.g., fever, headache, and myalgia). In most cases, symptoms resolve spontaneously after a week. [amboss.com]

• Confusion

  This interest has prompted confusion and anxiety among recreational water user groups such as canoeists who had not previously seen themselves as being particularly at risk. [ncbi.nlm.nih.gov]

  […] cases have been reported in which the etiologic agent was shown to be L. icterohaemorrhagiae.4 In these thirteen cases the clinical course did not differ materially from the usual course.5 In five cases the diagnosis was not made until autopsy.6 Some confusion [jamanetwork.com]

  Sometimes the fever may fluctuate and other symptoms such as a rash, jaundice, confusion, depression, kidney failure, liver failure and meningitis may occur. The incubation period is usually 10 days but can range from 4 to 19 days. [hellandback.ie]

  It is vital that the doctor be told of any waterborne activity you have been involved in as the symptoms are easily confused with those of flu and if you have an otherwise ‘clean occupation’ the possibility of Weil’s Disease may be overlooked in the early [rya.org.uk]

Because of the possibly life-threatening outcome of Weil's disease, the diagnosis must be made as early as possible. Signs and symptoms of Weil's disease and the initial stages of leptospirosis are not specific for the disease, making a detailed patient history pivotal in identifying recent exposure to contaminated waters, either through the occupational setting (veterinarians, farm and rice workers, hunters, shelter workers, etc.) or during recreational activities (swimming, fishing, caving, rowing) [2]. Furthermore, a thorough physical examination can reveal the potential site where the bacteria may have gained entry into the circulation, but also assess the extent of symptoms and organ involvement, after which a meticulous laboratory workup is necessary. A complete blood count (CBC) renal and kidney function tests, urinalysis and in the setting of meningitis-like symptoms, a lumbar puncture are vital [4]. Typical findings for leptospirosis and Weil's disease are leukocytosis, thrombocytopenia, elevated blood urea nitrogen (BUN), creatinine, and liver transaminases (alanine and aspartate aminotransferases, or ALT and AST), hyperbilirubinemia, proteinuria, pyuria, hematuria, and pleocytosis in the cerebrospinal fluid (CSF), respectively [4] [6] [7]. Moreover, serum inflammatory markers, such as erythrocyte sedimentation rate (ESR), will also be raised [4] [6]. A definite diagnosis, however, is made after confirming Leptospira in urine, blood, or CSF obtained from the patient. In the initial stages of the infection (first 10 days), microscopic detection of bacteria from any of the mentioned samples is widely recommended, primarily because results are provided within the hour, whereas cultivation, equally effective in the first several days, takes at least a few weeks to yield conclusive results [2] [3] [4]. However, low specificity/sensitivity rates require additional testing in most cases [3]. Thus, confirmation of immunoglobulin (Ig) M-specific antibodies through microscopic agglutination test (MAT) or enzyme-linked immunoassay (ELISA) and use of molecular methods - polymerase chain reaction (PCR), are advocated in the later stages of the disease [3] [4] [5] [6].

• Pyuria

  Typical findings for leptospirosis and Weil's disease are leukocytosis, thrombocytopenia, elevated blood urea nitrogen (BUN), creatinine, and liver transaminases (alanine and aspartate aminotransferases, or ALT and AST), hyperbilirubinemia, proteinuria, pyuria [symptoma.com]

  Kidney abnormalities may include the appearance of protein (proteinuria), pus (pyuria), or blood in the urine (hematuria), and an excess of urea in the blood (azotemia). The kidney is often enlarged, and its capsule is tense. [rarediseases.org]

• Neutrophilia

  A normal leukocyte count with neutrophilia and negative dengue NS1, dengue IgM, and Salmonella typhi IgM on admission should raise suspicion of leptospirosis, and prompt diagnostic assays for leptospirosis should be conducted. [ncbi.nlm.nih.gov]

Andere Ausgaben - Alle anzeigen Stitt's Diagnosis, Prevention and Treatment of Tropical Diseases, Band 2 Edward Rhodes Stitt, Richard Pearson Strong Auszug - 1944 Stitt's Diagnosis, Prevention and Treatment of Tropical Diseases, Band 2 Edward Rhodes Stitt [books.google.com]

Outcomes of treatment for all randomized patients. Overall outcomes of treatment (i.e., death and clinical treatment failure, duration of fever, and duration of organ dysfunction after treatment) were similar among the 3 treatment groups. [doi.org]

Role of various antibiotics in treatment of leptospirosis is uncertain, and can be attributed to nonavailability of adequate clinical trials. Role of penicillin in the treatment of leptospirosis can be debated. [ncbi.nlm.nih.gov]

The prognosis of all these patients, including that of Weil's disease was excellent. Early recognition and initiation of antibiotic therapy were found to be important. [ncbi.nlm.nih.gov]

Prognosis of Leptospirosis (Weil’s disease/syndrome; Icterohemorrhagic fever) Generally the prognosis related to this disease is good, usually with full recovery following infection. [healthengine.com.au]

Prognosis of leptospirosis-AKI is usually favourable unless complicated by multiple organ involvement. [elsevier.es]

After age 50 the prognosis for Weil syndrome is less optimistic than for younger people. [rarediseases.org]

Etiology Pathogen: Leptospira; (especially L. interrogans; ) is a genus of gram-negative spirochete bacteria. [amboss.com]

Inada and his co-workers 2 in a remarkable series of reports delineated the clinical and pathological picture, described the etiological agent and named it Spirochaeta icterohaemorrhagica. [annals.org]

[…] causative organism, later named Leptospira icterohaemorrhagiae.2 Since 1916 cases have been reported from Europe, Asia, Africa, South America and North America and Australia.3 In the United States and Canada thirteen cases have been reported in which the etiologic [jamanetwork.com]

Etiologic Agent Leptospires are long, thin, motile spirochetes. They may be free-living or associated with animal hosts and survive well in fresh water, soil, and mud in tropical areas. [web.archive.org]

The causative pathogen and epidemiological determinants were identified years later. [ajtmh.org]

The epidemiology of leptospirosis has been modified by changes in animal husbandry, climate, and human behavior. Resurgent interest in leptospirosis has resulted from large outbreaks that have received significant publicity. [ncbi.nlm.nih.gov]

Epidemiological data refers to the US, unless otherwise specified. Etiology Pathogen: Leptospira; (especially L. interrogans; ) is a genus of gram-negative spirochete bacteria. [amboss.com]

The aim of this article is to provide clinicians with a concise review of the epidemiology, pathophysiology, clinical features, diagnosis, management and prevention of leptospirosis. [ncbi.nlm.nih.gov]

> ;Open Forum Infect Dis. 2019 Apr 19 Methicillin-Resistant Staphylococcus aureus Prosthetic Valve Endocarditis: Pathophysiology, Epidemiology, Clinical Presentation, Diagnosis, and Management. Galar, A., Weil, A. A., Dudzinski, D. [doximity.com]

@article{Galar2019MethicillinResistantSA, title={Methicillin-Resistant Staphylococcus aureus Prosthetic Valve Endocarditis: Pathophysiology, Epidemiology, Clinical Presentation, Diagnosis, and Management.}, author={Alicia Galar and Ana A Weil and David [semanticscholar.org]

Create a Portfolio Articles Methicillin-Resistant Staphylococcus aureus Prosthetic Valve Endocarditis: Pathophysiology, Epidemiology, Clinical Presentation, Diagnosis, and Management cmr.asm.org — Review Alicia Galar, Ana A. Weil, David M. [muckrack.com]

Advances in hematology 2009, 200982009Methicillin-resistant Staphylococcus aureus prosthetic valve endocarditis: pathophysiology, epidemiology, clinical presentation, diagnosis, and management A Galar, AA Weil, DM Dudzinski, P Muñoz, MJ Siedner Clinical [scholar.google.com]

Gaps in understanding and of adherence to preventive advice were identified. Accordingly, it was concluded that health education for canoeists could be improved. [ncbi.nlm.nih.gov]

Andere Ausgaben - Alle anzeigen Stitt's Diagnosis, Prevention and Treatment of Tropical Diseases, Band 2 Edward Rhodes Stitt, Richard Pearson Strong Auszug - 1944 Stitt's Diagnosis, Prevention and Treatment of Tropical Diseases, Band 2 Edward Rhodes Stitt [books.google.com]

Surveillance The attached excerpt provides WHO recommended standards and strategies for the surveillance, prevention and control of Leptospirosis. [who.int]

[…] of Mosquito-borne diseases) ( Web Accessible Version) स्कारलेट बुखार की रोकथाम (Prevention of Scarlet Fever) आलेख जानकारी (Infographics) ( Web Accessible Version) न्यूमोकोक्कल संक्रमण की रोकथाम वृद्धों को न्यूमोकोक्कल टीका लगाया जाएगा (Prevent Pneumococcal [chp.gov.hk]

1. Niloofa R, Fernando N, de Silva NL, et al. Diagnosis of Leptospirosis: Comparison between Microscopic Agglutination Test, IgM-ELISA and IgM Rapid Immunochromatography Test. Dellagostin OA, ed. PLoS ONE. 2015;10(6):e0129236.
2. Haake DA, Levett PN. Leptospirosis in Humans. Curr Top Microbiol Immunol. 2015;387:65-97.
3. Musso D, La Scola B. Laboratory diagnosis of leptospirosis: a challenge. J Microbiol Immunol Infect. 2013;46(4):245-252.
4. Budihal SV, Perwez K. Leptospirosis Diagnosis: Competancy of Various Laboratory Tests. J Clin Diagn Res. 2014;8(1):199-202.
5. Kokudo T, Nakamura I, Nakamura-Uchiyama F, Komiya N, Ohnishi K. Weil's disease in a patient living in Tokyo. Intern Med. 2009;48(18):1707-1710.
6. Mandell GL, Bennett JE, Dolin R. Mandel, Douglas and Bennett's Principles and Practice of Infectious Diseases. 8th ed. Philadelphia, Pennsylvania: Churchill Livingstone; 2015.
7. Murray PR, Rosenthal KS, Pfaller MA. Medical Microbiology. Seventh edition. Philadelphia: Elsevier/Saunders; 2013.