Leptospirosis - Post-exposure Prophylaxis
Why do we give prophylaxis against Leptospirosis?
To prevent WEIL'S SYNDROME
 - Severe icteric form with ↑ mortality, 5-10% of all cases
 - Triad of 1) hemorrhage 2) jaundice 3) acute kidney injury
 - Classic hx: Wading in floods +conjunctival suffusion +calf tenderness
 - 50% of pts die of septic shock with multiorgan failure and/or bleeding in the lungs, GI, uro or skin
HISTORY OF WADING IN FLOOD
Low Risk:
 - Single exposure, no wounds/cuts/skin lesions
 - Doxycycline 2 capsules 100 mg single dose within 24 to 72 hours
Moderate Risk:
 - Single exposure, +wounds/cuts/skin lesions
 - Doxycycline 2 capsules 100 mg OD for 3-5 days to be started immediately within 24 to 72 hours from exposure
High Risk:
 - Continuous exposure, +/- wounds/cuts/skin lesions
 - Doxycycline 2 capsules 100 mg once weekly until the end of exposure

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