In leptospirosis, the following clinical features are seen except-
Correct Answer: Massive splenomegaly
Description: Clinical features After a relatively brief bacteraemia, invading organisms are distributed throughout the body, mainly in kidneys, liver, meninges and brain. The incubation period averages 1-2 weeks. Four main clinical syndromes can be discerned and clinical features can involve multiple different organ systems . Bacteraemic leptospirosis Bacteraemia with any serogroup can produce a non-specific illness with high fever, weakness, muscle pain and tenderness (especially of the calf and back), intense headache and photophobia, and sometimes diarrhoea and vomiting. Conjunctival congestion ,massive splenomegaly is the only notable physical sign. The illness comes to an end after about 1 week, or else merges into one of the other forms of infection. Aseptic meningitis Classically associated with L. canicola infection, this illness is very difficult to distinguish from viral meningitis. The conjunctivae may be congested but there are no other differentiating signs. Laboratory clues include a neutrophil leucocytosis, abnormal LFTs, and the occasional presence of albumin and casts in the urine . Ref Harrison20th edition pg 1099
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