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 response,

Attach to endothelial cells response, bacteria cleared hemolysis, lipolysis
Lucena City
Leakage
Capillary vasculitis Endothelial edema and Hypovolemia
s/sx: petchiae, intraparenchymal lymphatic inflammation,
bleeding, 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 jaundice
dysfunction
Decrease renal blood flow
Hepatocellular
dysfunction s/sx: yellow tinted skin
Decrease glomerular filtration 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
Accumulation of bacteria
the small vessels
Cardiac lesion
LESIONS
s/sx: rapid
Interstitial myocarditis heartbeat,
Alveolar and interstitial and Pulmonary edema and s/sx: cough, chest pain,
ventricular
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
Lesions
s/sx: Petechia, Lesions

Vascular epithelial injury rashes, edema,
yellowish
Myofibril vacuolization s/sx: weakness,
discoloration, pain
fatigue, muscle pain,
in the skin
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 response,

Attach to endothelial cells response, bacteria cleared hemolysis, lipolysis
Lucena City
Leakage
Capillary vasculitis Endothelial edema and
s/sx: petchiae, intraparenchymal lymphatic inflammation,
bleeding, 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 jaundice
dysfunction
Decrease renal blood flow
Hepatocellular
dysfunction s/sx: yellow tinted skin
Decrease glomerular filtration 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 and Pulmonary edema and s/sx: cough, chest pain,
ventricular
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
Lesions
s/sx: Petechia,
Vascular epithelial injury rashes, edema,
yellowish
Myofibril vacuolization s/sx: weakness,
discoloration, pain
fatigue, muscle pain,
in the skin
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 dissemination

SEPTIC STAGE 4-7 days

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

Induced endotoxins Phagocytosis Release of IgG antibodies

Adequate immune Inadequate immune response,

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

Further loss of nephron DIC

INTEGUMENTARY SKELETAL MUSCLE

s/sx: Petechia, Lesions

Increase capillary permeability

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 dissemination

SEPTIC STAGE 4-7 days

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

Induced endotoxins Phagocytosis Release of IgG antibodies

Adequate immune Inadequate immune response,

Bacteria proliferates in the

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

Further loss of nephron DIC

INTEGUMENTARY SKELETAL MUSCLE

Increase capillary permeability

S/Sx: headache, neck

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