Diagnosis

Known risk factors include:

• Agricultural work

• Exposure to contaminated water

• Flooding

• Microscopic agglutination test (MAT) – Recognized gold standard reference test for serological diagnosis

• Complete picture – leucocytosis

• Demonstration of the organism under dark field microscopy from blood, serum, fresh urine

• Organisms can be found in blood within 4 days of symptoms

• Specific diagnosis by serology

  • Antibodies may be detected in the blood within 5-7 days of symptom onset
  • Confirmation requires seroconversion between acute and convalescent phase serum specimens

• Demonstration of Leptospira in a clinical specimen by immunofluorescence

• Molecular - Quantitative PCR on serum or urine is a reliable diagnostic investigation early in the course of the illness if available

• Monitoring of liver and renal function

• Total and differential protein and DP

• Clotting profile

• Blood glucose

• CSF findings in patients with cerebral involvement are consistent with aseptic meningitis