It is classically caught from water contaminated with rat's urine, so suspect it as a diagnosis in those in questions who have recently fallen into rivers/out of rowing boats.
After a 2 to 20 day incubation period the patient develops:
- fever
- myalgia
- cough/haemoptysis
- headache
The patient then either makes a good recovery or develops:
- meningitis
- jaundice
- renal failure (50%)
Treatment is with penicillin/amoxicillin/doxycycline.
Lets move on to some conversions...
