General Pathophysiology of Leptospirosis 1 (Autorecovered)

Manuel S.
Enverga University Foundation

Lucena City
Granted Autonomous Status
CHED CEB Res.076-2009
COLLEGE OF NURSING & ALLIED HEALTH SCIENCES
GENERAL PATHOPHYSIOLOGY OF LEPTOSPIROSIS

(BOOK BASED)
MODIFIABLE FACTORS ETIOLOGIC AGENTS NON-MODIFIABLE FACTORS

Occupational exposure: Leptospira (L. interrogans) Age
-Farmers L. icterohaemorrhagiae Sex
-Veterinarians L. bataviae Geographic
-Rice field workers L. canicola Season
-Butchers L. grippotyphosa
Recreational activities:
-Fresh water swimming
-Canoeing
-Kayaking
-Trail biking in warm areas
Household exposure:
-Pet dogs
-domestic livestock
-Infected rodents
Leptospira lives in the kidneys of animals
Portal exit through urine
Contaminates the water and soil

Manuel S. Enverga University Foundation
Lucena City
Bacteria enters through break in the skin, mouth, and eyes
Incubates for 6-15 days asymptomatic
Proliferation and widespread

dissemination
SEPTIC STAGE 4-7 days
S/sx: - chills, fever, increase RR and HR,

Bacteria enters the bloodstream
abdominal pain, headache,
Induced endotoxins Phagocytosis Release of IgG antibodies
Adequate immune Inadequate immune

Attach to endothelial cells
response, bacteria cleared response, hemolysis, lipolysis
Lucena City
Leakage
s/sx: petchiae, Capillary vasculitis Endothelial edema and Hypovolemia

intraparenchymal bleeding, lymphatic inflammation,
bleeding long serosa and
mucosa s/sx: low BP, increase HR, weak
Bacteria proliferates in the pulse, shallow breathing,
blood profuse breathing, and decrease
urine output
Distributed around the body via s/sx: lymphadenopathy,

lymphatic involvement fever, chills, malaise, loss
of appetite, headache.
IMMUNE/TOXIC STAGE CONVALESCENCE Relapse occur during

4-30 Days
STAGE 4th-5th week
Organ system affectation

Lucena City
KIDNEYS
LIVER
Accumulation of bacteria in the

renal tubules and tubular Accumulation of bacteria in
lumen the lobes
Development of interstitial and Centribular necrosis and

tubular necrosis kupffer cell proliferation
Vascular damage
Hypervolemia
Hepatocellular Hepatocellular
dysfunction jaundice
Decrease renal blood flow
Hepatocellular
Decrease glomerular filtration dysfunction s/sx: yellow tinted skin
Increase BUN and
and eyes, inflammation
serum creatinine
of the liver
Further loss of nephron DIC

function
Hypovolemia
Decrease renal function
RENAL
FAILURE
Lucena City
PULMONARY
CVS
Accumulation of bacteria
in the small vessels
Cardiac lesion
LESIONS
s/sx: rapid
Interstitial myocarditis heartbeat,
Alveolar and interstitial Pulmonary edema and s/sx: cough, chest pain,
ventricular
and vascular damage fibrin deposition mild to severe hemoptysis
tachycardia,
to ARDS, tachypnea,
dyspnea, pulmonary
cyanosis
edema
Pulmonary hemorrhage S/sx: Hemoptysis
Lucena City
INTEGUMENTARY SKELETAL MUSCLE
INTEGUMENTARY INTEGUMENTARY
Lesions
s/sx: Petechia, Lesions

Vascular epithelial injury rashes, edema,
yellowish s/sx: weakness,
discoloration, pain Myofibril vacuolization
fatigue, muscle
in the skin pain, chills
Vessel damage
Increase capillary permeability
Fluid leakage
Circulatory hypovolemia s/sx: hypovolemic,

tachypnea
Shock
Lucena City
CNS
EYES
S/Sx: headache, neck

Coagulopathy and meningitis stiffness, confusion, psychosis, S/Sx: orange color sclera Conjunctivitis and iritis
delirium
Lucena City
CLIENT BASED
MODIFIABLE FACTORS ETIOLOGIC AGENTS NON-MODIFIABLE FACTORS

Occupational exposure: Leptospira (L. interrogans)
-F Household exposure:
-Infected rodents
armers male
-Veterinarians Geographic area: prevalent in slum areas
-Rice field workers Season: rainy month
-Butchers L.
-Trail biking in warm areas
Leptospira lives in the kidneys of animals
Portal exit through urine
Contaminates the water and soil

Lucena City
Bacteria enters through break in the skin, mouth, and eyes
Incubates for 6-15 days asymptomatic
Proliferation and widespread

dissemination
SEPTIC STAGE 4-7 days
S/sx: - chills, fever, increase RR and HR,

Bacteria enters the bloodstream
abdominal pain, headache,
Induced endotoxins Phagocytosis Release of IgG antibodies
Adequate immune Inadequate immune

Attach to endothelial cells
response, bacteria cleared response, hemolysis, lipolysis
Lucena City
Leakage
s/sx: petchiae, Capillary vasculitis Endothelial edema and

intraparenchymal bleeding, lymphatic inflammation,
bleeding long serosa and
mucosa
Bacteria proliferates in the
blood
Distributed around the body via s/sx: lymphadenopathy,

lymphatic involvement fever, chills, malaise,
loss of appetite,
headache.
IMMUNE/TOXIC STAGE CONVALESCENCE Relapse occur during

4-30 Days
STAGE 4th-5th week
Organ system affectation

Lucena City
KIDNEYS
LIVER
Accumulation of bacteria in the

renal tubules and tubular Accumulation of bacteria in
lumen the lobes
Development of interstitial and Centribular necrosis and

tubular necrosis kupffer cell proliferation
Vascular damage
Hypervolemia
Hepatocellular Hepatocellular
dysfunction jaundice
Decrease renal blood flow
Hepatocellular
Decrease glomerular filtration dysfunction s/sx: yellow tinted skin
Increase BUN and and eyes, inflammation
serum creatinine
of the liver
Further loss of nephron DIC

function
Hypovolemia
Decrease renal function
RENAL
FAILURE
Lucena City
PULMONARY
CVS
in the small vessels
Cardiac lesion
LESIONS
s/sx: rapid
Interstitial myocarditis heartbeat,
Alveolar and interstitial Pulmonary edema and s/sx: cough, chest pain,
ventricular
and vascular damage fibrin deposition mild to severe hemoptysis
tachycardia,
to ARDS, tachypnea,
dyspnea, pulmonary
cyanosis
edema
Pulmonary hemorrhage S/sx: Hemoptysis
Lucena City
INTEGUMENTARY SKELETAL MUSCLE
INTEGUMENTARY INTEGUMENTARY
Lesions
s/sx: Petechia,
Vascular epithelial injury rashes, edema,
yellowish s/sx: weakness,
discoloration, pain Myofibril vacuolization
fatigue, muscle
in the skin pain, chills
Vessel damage
Increase capillary permeability
Fluid leakage
Circulatory hypovolemia s/sx: hypovolemic,

tachypnea
Shock
Lucena City
CNS
EYES
S/Sx: headache, neck

Coagulopathy and meningitis stiffness, confusion, psychosis, S/Sx: orange color sclera Conjunctivitis and iritis
delirium

General Pathophysiology of Leptospirosis 1 (Autorecovered)

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Manuel S.

Enverga University Foundation

GENERAL PATHOPHYSIOLOGY OF LEPTOSPIROSIS

MODIFIABLE FACTORS ETIOLOGIC AGENTS NON-MODIFIABLE FACTORS

Leptospira lives in the kidneys of animals

Portal exit through urine

Contaminates the water and soil

Bacteria enters through break in the skin, mouth, and eyes

Incubates for 6-15 days asymptomatic

Proliferation and widespread

SEPTIC STAGE 4-7 days

S/sx: - chills, fever, increase RR and HR,

Induced endotoxins Phagocytosis Release of IgG antibodies

Adequate immune Inadequate immune

s/sx: petchiae, Capillary vasculitis Endothelial edema and Hypovolemia

Distributed around the body via s/sx: lymphadenopathy,

IMMUNE/TOXIC STAGE CONVALESCENCE Relapse occur during

Organ system affectation

Accumulation of bacteria in the

Development of interstitial and Centribular necrosis and

Further loss of nephron DIC

INTEGUMENTARY SKELETAL MUSCLE

s/sx: Petechia, Lesions

Increase capillary permeability

Circulatory hypovolemia s/sx: hypovolemic,

S/Sx: headache, neck

MODIFIABLE FACTORS ETIOLOGIC AGENTS NON-MODIFIABLE FACTORS

-Trail biking in warm areas

Leptospira lives in the kidneys of animals

Portal exit through urine

Contaminates the water and soil

Bacteria enters through break in the skin, mouth, and eyes

Incubates for 6-15 days asymptomatic

Proliferation and widespread

SEPTIC STAGE 4-7 days

S/sx: - chills, fever, increase RR and HR,

Induced endotoxins Phagocytosis Release of IgG antibodies

Adequate immune Inadequate immune

s/sx: petchiae, Capillary vasculitis Endothelial edema and

Distributed around the body via s/sx: lymphadenopathy,

IMMUNE/TOXIC STAGE CONVALESCENCE Relapse occur during

Organ system affectation

Accumulation of bacteria in the

Development of interstitial and Centribular necrosis and

Further loss of nephron DIC

INTEGUMENTARY SKELETAL MUSCLE

Increase capillary permeability

Circulatory hypovolemia s/sx: hypovolemic,

S/Sx: headache, neck

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