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Review
. 2021 Feb 1;10(2):145.
doi: 10.3390/pathogens10020145.

Leptospiral Infection, Pathogenesis and Its Diagnosis-A Review

Antony V Samrot  1 , Tan Chuan Sean  1 , Karanam Sai Bhavya  2 , Chamarthy Sai Sahithya  2 , SaiPriya Chan-Drasekaran  2 , Raji Palanisamy  2 , Emilin Renitta Robinson  3 , Suresh Kumar Subbiah  4   5   6 , Pooi Ling Mok  5   6   7   8
Affiliations
Review

Leptospiral Infection, Pathogenesis and Its Diagnosis-A Review

Antony V Samrot et al. Pathogens. .

Abstract

Leptospirosis is a perplexing conundrum for many. In the existing literature, the pathophysiological mechanisms pertaining to leptospirosis is still not understood in full. Considered as a neglected tropical zoonotic disease, leptospirosis is culminating as a serious problem worldwide, seemingly existing as co-infections with various other unrelated diseases, including dengue and malaria. Misdiagnosis is also common as non-specific symptoms are documented extensively in the literature. This can easily lead to death, as the severe form of leptospirosis (Weil's disease) manifests as a complex of systemic complications, especially renal failure. The virulence of Leptospira sp. is usually attributed to the outer membrane proteins, including LipL32. With an armament of virulence factors at their disposal, their ability to easily adhere, invade and replicate within cells calls for a swift refinement in research progress to establish their exact pathophysiological framework. As an effort to reconstitute the current knowledge on leptospirosis, the basis of leptospiral infection, including its risk factors, classification, morphology, transmission, pathogenesis, co-infections and clinical manifestations are highlighted in this review. The various diagnostic techniques are also outlined with emphasis on their respective pros and cons.

Keywords: diagnosis; leptospiral proteins; leptospirosis; pathogenesis.

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Conflict of interest statement

The authors declare no conflict of interest

Figures

Figure 1
Figure 1
Illustration depicting the relationship between pathogenic, intermediate and saprophytic Leptospira and the distinct differences between them.
Figure 2
Figure 2
Illustration depicting the outer layers of Leptospira species, highlighting the various proteins found on the outer membrane.
Figure 3
Figure 3
Pictorial representation of notable leptospiral proteins [44,51,52,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73,74,75,76,77,78].
Figure 4
Figure 4
Summary of the transmission and pathogenesis framework in leptospirosis.
Figure 5
Figure 5
Summary of the clinical manifestations seen in leptospirosis.
Figure 6
Figure 6
ELISA using IgM and IgG antibody for leptospiral diagnosis.
Figure 7
Figure 7
Illustration depicting the principles of IHA to detect leptospires (A) positive reaction and (B) negative reaction.
Figure 8
Figure 8
Illustration depicting dipstick assay.
See this image and copyright information in PMC

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