- Contract via exposure to infected rodent/small mammal urine
- Can be acquired anywhere, in partic Carribean, Southeast Asia, Central America, Sub-tropics
- Enters body via inhalation, mucosal exposure, skin break
- Often via wading in fresh water
- Incubation days to several weeks
- Most get mild dz→ self limited f, c, ha, confusion, n, v, muscle aches
- Severe dz f, c, sob, cough, hemoptysis (pulmonary hemorrhage), renal failure, jaundice, sepsis
- Weil Syndrome: severe form of leptospirosis with AKI, liver failure, pulmonary and other organ involvement
- Conjunctival injection
- Sometimes transient petechial rash, can involve palate
- Severe dz with hepatic, CNS and renal involvement, pulmonary hemorrhage, jaundice, and icterus