钩端螺旋体病：一种通过工作、娱乐和旅行获得的重要动物源性传染病。
Leptospirosis: An important zoonosis acquired through work, play and travel.
机构信息
MBBS, MPH@TM, PhD, FRACGP, NHMRC Fellow, Department of Global Health, Research School of Population Health, Australian National University, Canberra, ACT; Travel Medicine Consultant, Travel Medicine Alliance Clinics Australia.
MBChB, BSc, FRCPA, FRACP, Infectious Disease Physician, Infectious Disease Department, Mater Hospital Brisbane, Mater Health, South Brisbane, Qld.
出版信息
Aust J Gen Pract. 2018 Mar;47(3):105-110. doi: 10.31128/AFP-07-17-4286.
BACKGROUND
Leptospirosis is one of the most common zoonotic diseases worldwide. Infection occurs through contact with infected animals, or soil or water that has been contaminated by the urine of infected animals. Risk factors include occupational and recreational exposures, contact with floodwaters, and travel to areas with a high risk of leptospirosis, particularly tropical, developing countries. With climate change, flood-related outbreaks are becoming more common.
OBJECTIVE
This article aims to improve awareness of leptospirosis, and provide an update for general practitioners on its epidemiology, risk factors, clinical presentation, laboratory diagnosis, management and prevention.
DISCUSSION
Leptospirosis is sometimes misdiagnosed because clinical presentation can be non-specific and overlap with many other causes of acute febrile illnesses. In patients with risk factors for leptospirosis, a high index of clinical suspicion is important to ensure early diagnosis and treatment. Delays in treatment could increase the risk of severe complications, including pulmonary haemorrhage, acute renal failure and acute liver failure.
背景
钩端螺旋体病是全球最常见的人畜共患疾病之一。感染通过接触受感染的动物、或被受感染动物尿液污染的土壤或水而发生。危险因素包括职业和娱乐性暴露、接触洪水，以及前往钩端螺旋体病高发地区（尤其是热带发展中国家）旅行。随着气候变化，与洪水有关的暴发越来越常见。
目的
本文旨在提高对钩端螺旋体病的认识，并为全科医生提供有关其流行病学、危险因素、临床表现、实验室诊断、治疗和预防的最新信息。
讨论
由于临床表现可能不具特异性并与许多其他急性发热性疾病相重叠，因此钩端螺旋体病有时会被误诊。对于有钩端螺旋体病危险因素的患者，重要的是要高度怀疑临床，以确保早期诊断和治疗。治疗延迟会增加发生严重并发症的风险，包括肺出血、急性肾衰竭和急性肝衰竭。
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