Leptospirosis physical examination

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Venkata Sivakrishna Kumar Pulivarthi M.B.B.S [2]

Physical examination findings of leptospirosis depends upon the severity of the disease. In the early days of the disease, patient may show signs of upper respiratory tract infections, later findings varies with the severity of the disease, immune status of the host and the organ system involved.

• Patient present with irritability and restlessness.

• Hypotension and circulatory collapse.
• Tachypnea
• Tachycardia

• Macular, maculopapular erythematous skin eruptions are seen in the face and trunk.^[1]
• Purpura due to thrombocytopenia.

• Icteric sclera is seen in patients with icteric leptospirosis
• Conjunctival suffusion: a charecterestic finding seen in patients with anicteric leptosirosis. Usually bilaeral and involving palpebral conjunctiva.^[2]
• Conjunctival hemorrhages: may be unilateral or bilateral.^[3]

• Crepitations common in basal regions

• Right upper quadrant tenderness^[4]

• Hepatomegaly

• Edema of the extremities
• cold clammy extremities

Signs of meningitis such as neck stiffness, nuchal rigidity are present.

Other signs include:

• Nystagmus
• Spasticity