Primary neuroleptospirosis
J N Panicker, R Mammachan, R V Jayakumar
Department of
Medicine, Medical College, Thiruvananthapuram, Kerala, India
Correspondence to: Dr Jalesh N Panicker, `Tatsat' TC 14 / 1024-1, Rosscote Lane, Thiruvananthapuram 695010, India tatsat{at}vsnl.com
Submitted 31 August
2000;
Accepted 10 January 2001
Leptospirosis is an important zoonosis of worldwide
distribution. It is uncommon for leptospirosis to present as a primary neurological disease. In this study of patients who presented with an
acute neurological disease, and who were subsequently found to have
leptospirosis, aseptic meningitis was the commonest manifestation. The
other presentations were myeloradiculopathy, myelopathy,
Guillain-Barré syndrome-like presentation, meningoencephalitis, intracerebral bleed, cerebellar dysfunction, iridocyclitis, and tremor/rigidity. Treatment consists of antibiotics, crystalline penicillin being the drug of choice, which reduces the course of
illness if given early. The role of steroids is controversial. The
prognosis after primary neuroleptospirosis is generally good but
altered sensorium and seizures herald a worse prognosis.
Keywords: neuroleptospirosis; aseptic meningitis; Weil's disease
© 2001 by The Fellowship of Postgraduate Medicine
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