Leptospirosis

For a lay person:

Leptospirosis is a bacterial infection caught from water or soil contaminated by the urine of infected animals, especially rats, often after flooding, farming or water sports. It can be a mild flu-like illness, but severe cases damage the liver, kidneys and lungs and can be fatal.

For a trained medical person:

Caused by pathogenic Leptospira species entering through skin abrasions or mucous membranes; severe disease includes Weil's syndrome with jaundice, acute kidney injury and bleeding, and pulmonary haemorrhage syndrome. Diagnosis is by PCR early in illness and serology later, with blood and urine tests of organ function. Treatment is early antibiotics such as doxycycline for mild disease and intravenous penicillin or ceftriaxone for severe disease, with supportive care including dialysis and ventilation.

In Chinese medicine:

Liu and Tseng's textbook differentiates this condition into these patterns: Damp Obstructing the Upper Jiao; Evil Pathogens Accumulating at Qi Level; Jaundice, Bleeding Type; Pulmonary Hemorrhage Type; Meningoencephalitis Type; Renal Failure Type. Treatment follows the pattern a patient presents with, not the Western diagnosis alone.

When to get help: Get urgent medical care for fever after contact with floodwater, animals or fresh water, especially with jaundice, reduced urine, breathlessness or bleeding; it is notifiable in many countries and needs antibiotics, with Chinese medicine adjunctive at most.