Csd

5 mm

Figure 25.3 Leptospira interrogans, the Cause of Leptospirosis Note the hooked ends of this spirochete.

5 mm

Figure 25.3 Leptospira interrogans, the Cause of Leptospirosis Note the hooked ends of this spirochete.

the site of entry, but the organisms multiply and spread throughout the body by way of the bloodstream, penetrating all tissues including the eyes and the brain. Severe pain is characteristic of this first (septicemic) phase, and it may lead to unnecessary surgery for suspected appendicitis or gallbladder infection. A lack of inflammatory changes or tissue damage is a striking feature. Within a week, type-specific antibody arises and with complement destroys the organisms present in most tissues, although they continue to multiply in the kidneys. The victim then characteristically enjoys 1 or more days of improvement before symptoms recur. The cause of the recurrent symptoms is presumed to be an immune response, and this second phase of the illness is often called the immune phase. This phase is characterized by injury to the cells that line the lumen of tiny blood vessels, causing clotting and impaired blood flow in tissues throughout the body. This accounts for most of the serious effects of the illness, including kidney failure, the main cause of fatalities. ■ complement system, p. 381

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