Prognoses for human leptospirosis

Prognoses for human leptospirosis - professional guide

On the vast majority of cases, patients recover within one or two months. A significant number show medium-term health issues due to persistent infection however many patients who are subclinical at the acute stage will not notice any deficit. Fatigue commonly remains for longer than all other symptoms, and patients can often require at least 8 weeks off work to regain their strength and vitality.

In untreated cases where the infection is moderate to severe, mortality is between 10% and 40% with the primary COD being renal and liver failure or myocarditis, although in severe cases haemorrhagia and respiratory involvement can be significant enough to cause death. With prompt antibiotic therapy the mortality is reduced to very low levels, even in severe infections, and is typically reported at between 1% and 10%. There are however some symptoms known to associate with a poor prognosis, namely oliguria, ECG repolarisation artefacts, respiratory involvement (dyspnea and infiltration) and significant leucocytosis. Jaundice, however, is not a significant prognostic indicator and many patients with severe jaundice make a full recovery.

Long-term issues are far more common in spirochaetal infections than in others, and patients will often require supervision and some management for several years, both for physical and psychological factors. Recurrent headaches, depression and uveitis are to be expected and can remain a problem for several years, so it is important to retain contact with the patient and explain these likely symptoms before discharge.

The Leptospirosis Information Center

Prognoses for human leptospirosis - professional guide

See also