Slack Andrew
Griffith University, Gold Coast, Queensland.
Aust Fam Physician. 2010 Jul;39(7):495-8.
This article forms part of our travel medicine series for 2010, providing a summary of prevention strategies and vaccination for infections that may be acquired by travellers. The series aims to provide practical strategies to assist general practitioners in giving travel advice, as a synthesis of multiple information sources which must otherwise be consulted.
Leptospirosis is one of the many diseases responsible for undifferentiated febrile illness, especially in the tropical regions or in the returned traveller. It is a disease of global importance, and knowledge in the disease is continually developing.
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.
Leptospirosis should be included in the broad differential diagnosis of febrile illness. The clinical manifestations of the disease vary from mild, nonspecific illness through to severe illness resulting in acute renal failure, hepatic failure and pulmonary haemorrhage. Diagnosis is dependant on accurate prediction of the time of infection: culture, polymerase chain reaction and serology may be used to confirm the diagnosis. Management is centred on prompt antibiotic therapy using doxycycline or intravenous penicillin G or intravenous ceftriaxone/cefotaxime. Prevention of leptospirosis revolves around the 'cover-wash-clean up' strategy.
本文是我们2010年旅行医学系列文章的一部分，总结了旅行者可能感染的疾病的预防策略和疫苗接种情况。该系列旨在提供实用策略，以帮助全科医生提供旅行建议，综合了多种信息来源，否则这些信息来源需另行查阅。
钩端螺旋体病是导致不明原因发热疾病的众多疾病之一，特别是在热带地区或归国旅行者中。它是一种具有全球重要性的疾病，对该疾病的认识也在不断发展。
本文旨在为临床医生提供有关钩端螺旋体病的流行病学、病理生理学、临床特征、诊断、管理和预防的简要综述。
钩端螺旋体病应纳入发热疾病的广泛鉴别诊断中。该疾病的临床表现从轻度、非特异性疾病到导致急性肾衰竭、肝衰竭和肺出血的严重疾病不等。诊断取决于对感染时间的准确预测：培养、聚合酶链反应和血清学可用于确诊。管理以使用强力霉素或静脉注射青霉素G或静脉注射头孢曲松/头孢噻肟进行及时抗生素治疗为中心。钩端螺旋体病的预防围绕“遮盖-清洗-清理”策略展开。
