Ricaldi Jessica N, Vinetz Joseph M
Division of Infectious Diseases, Department of Medicine, University of California San Diego School of Medicine, 9500 Gilman Drive, 0640, Cellular and Molecular Medicine-East, Room 2052, La Jolla, CA 92093-0640, USA.
Curr Infect Dis Rep. 2006 Jan;8(1):51-8. doi: 10.1007/s11908-006-0035-3.
Leptospirosis, caused by spirochetes of the genus Leptospira, has increasingly been recognized to affect travelers and residents in tropical settings. A zoonotic disease, leptospirosis is transmitted to humans through environmental surface waters contaminated by the urine of chronically infected mammals. Outcome of infection varies, ranging from acute febrile illness (including self-resolving undifferentiated fever) to aseptic meningitis to a fulminant syndrome of jaundice, oliguric renal failure, pulmonary hemorrhage, and refractory shock. Hospitalized cases have mortality rates as high as 25%. A recent clinical trial showed that third-generation cephalosporin is as effective as doxycycline and penicillin in the treatment of acute disease. Doxycycline is effective in preventing leptospirosis in travelers. No protective vaccine is currently available.
钩端螺旋体病由钩端螺旋体属的螺旋体引起，越来越多的人认识到它会影响热带地区的旅行者和居民。钩端螺旋体病是一种人畜共患病，通过长期感染的哺乳动物尿液污染的环境地表水传播给人类。感染的结果各不相同，从急性发热性疾病（包括自行缓解的未分化发热）到无菌性脑膜炎，再到黄疸、少尿性肾衰竭、肺出血和难治性休克的暴发性综合征。住院病例的死亡率高达25%。最近的一项临床试验表明，第三代头孢菌素在治疗急性疾病方面与强力霉素和青霉素一样有效。强力霉素对预防旅行者感染钩端螺旋体病有效。目前尚无保护性疫苗。
