Leptospiral Infection, Pathogenesis and Its Diagnosis—A Review

Abstract

Leptospirosis is a perplexing conundrum for many. In the existing literature, the pathophysiological mechanisms pertaining to leptospirosis is still not understood in full. Considered as a neglected tropical zoonotic disease, leptospirosis is culminating as a serious problem worldwide, seemingly existing as co-infections with various other unrelated diseases, including dengue and malaria. Misdiagnosis is also common as non-specific symptoms are documented extensively in the literature. This can easily lead to death, as the severe form of leptospirosis (Weil’s disease) manifests as a complex of systemic complications, especially renal failure. The virulence of Leptospira sp. is usually attributed to the outer membrane proteins, including LipL32. With an armament of virulence factors at their disposal, their ability to easily adhere, invade and replicate within cells calls for a swift refinement in research progress to establish their exact pathophysiological framework. As an effort to reconstitute the current knowledge on leptospirosis, the basis of leptospiral infection, including its risk factors, classification, morphology, transmission, pathogenesis, co-infections and clinical manifestations are highlighted in this review. The various diagnostic techniques are also outlined with emphasis on their respective pros and cons.

Extracellular Proteome Analysis Shows the Abundance of Histidine Kinase Sensor Protein, DNA Helicase, Putative Lipoprotein Containing Peptidase M75 Domain and Peptidase C39 Domain Protein in Leptospira interrogans Grown in EMJH Medium

“…Alternatively, the development of efficient vaccines and drugs is also necessary. Rational development of diagnostic tools and vaccines requires a clear understanding of the molecules used as candidates or targets for this purpose [ 2 ]. Secretory proteins are a group of molecules from which better molecules for an anti-leptospiral strategy can be obtained because of their biological significance concerning pathogenesis and host-pathogen interactions [ 3 ].…”

Prevalence of Malaria and Leptospirosis Co-Infection among Febrile Patients: A Systematic Review and Meta-Analysis

“…Leptospirosis is one of the most important zoonotic diseases caused by pathogenic species of the spirochete bacteria Leptospira [ 16 , 17 ]. This disease is considered a neglected and re-emerging disease of global public health significance, which causes high mortality and morbidity in both humans and animals [ 18 , 19 ]. Nowadays, outbreaks of leptospirosis occur in tropical countries, particularly India, Malaysia, and Brazil [ 17 ].…”

“…Leptospirosis cases were found to increase due to heavy rainfall, flooding, and poor sanitation, which frequently occur in urban slum areas [ 20 , 21 ]. Previous studies demonstrated the incidence of leptospirosis increasing and being widespread in Italy, Pakistan, Japan, Nicaragua, the Philippines, and Sri Lanka [ 17 , 18 ]. At least 1 million leptospirosis cases have been reported worldwide, with nearly 60,000 deaths per year [ 22 ].…”

“…At least 1 million leptospirosis cases have been reported worldwide, with nearly 60,000 deaths per year [ 22 ]. The initial non-specific symptoms presenting as febrile illness can result in misdiagnosis with other diseases such as malaria, dengue, and Zika virus infections [ 18 , 23 ]. This can result in an increase in fatalities in the severe stage of leptospirosis (Weil’s disease) [ 18 ].…”

“…The initial non-specific symptoms presenting as febrile illness can result in misdiagnosis with other diseases such as malaria, dengue, and Zika virus infections [ 18 , 23 ]. This can result in an increase in fatalities in the severe stage of leptospirosis (Weil’s disease) [ 18 ]. Therefore, the early diagnosis of leptospirosis infection can decrease the severity of disease.…”