What is the pathophysiology of the calf pain in patients with leptospirosis?

Question

im working on the signs and symptoms of leptospirosis in humans for a report however, i can't figure out why a patient with such disease would manifest with calf pain.

Answer 1

Transmission, Development, and Pain

Leptospires are ubiquitous and abundant due to their abilities to infect a variety of animals and to persist outside the host. Transmission occurs through contact with contaminated water or contaminated food, during coitus, or through transplacental transmission. The leptospire bacteria have a predilection for the kidneys and the urinary tract where they may produce a persistent infection. The leptospire organisms may be excreted with the urine resulting in transmission of the bacteria. Infective urine constitutes the major sources of infection for humans, domestic animals and wild animals. Transmission usually occurs when there is direct contact between urine droplets or urine contaminated water and the mucous membranes of the eye, nose and mouth or through abraded skin. Transmission of the leptospire organisms may also occur through the food chain by the ingestion of leptospiral-infected carcasses by carnivorous species. This is the most significant mode of spread of leptospires among carnivores.

Humans usually are exposed by swimming in urine-contaminated water, or occupationally through exposure to an infected animal's urine.

The leptospire organisms can survive outside the body if environmental conditions are favorable. The bacteria prefer moist, slightly alkaline soil, stagnant ponds, and low-flow, slow-moving, slightly alkaline streams. In these conditions the organism can survive for several weeks.

Once infection has occurred, the leptospires multiply in the kidneys, lungs, reproductive organs and brain. Uterine penetration of pregnant animals results in infection of the fetuses.

The pain is intense and requires pain killers. The fact of 20% of humans who would die from the disease; the pain killer is thought to be an abrupt move. Caution is the best way to attack this disease, with the death toll remaining quite high. Although most patients have the calf pain, there will also be some with bisep. The disease settles in the large leg and arm muscles. If it goes to the heart muscle; that is automatic death.

Answer 2

People become infected with leptospiras (Leptospira interrogans) when the bacteria enter the blood either through broken skin or through mucous membranes. This is a significant public health problem in countries with poor water management.

To understand the answer to your question, know that these bacteria (the leptospiras) will circulate in the blood and deposit in many organs including the liver, kidneys, lungs, and in some cases even the central nervous system.

These deposits will produce not only a degree of loss-of-function of the particular organ, but also will elicit a general pyrogenic response (a fever). Therefore the pain in the calf may be due to one or a combination of these processes: the aches and pains that you get with any fever; the leptospiras are generating local inflammatory responses in the muscle; there is significant protein catabolism (usage) due to the fever, and because the liver is directly affected by the bacteria, there is a net protein loss and therefore significant muscle atrophy, and this gets the muscle tired more easily.

So bottomline: cure the leptospirosis in a reasonable time, and you ought to be able to avoid long-term complications.

You can write me if you need clarification.

Answer 3

It is possible that the patient has developed Well's Syndrome in some severe case. This might show up as a form of anemia. A calf pain could suggest that some form of internal bleeding has occured. Though based on the disease description it could simply be the result of the person's occupation, ie being a farmer, the type of person who is likely to get leptospirosis. Calf pain may be a kind of Plantar Fasciitis from standing around for long periods of time.

Answer 4

I believe leptospirosis causes muscle pains in general (also high fevers which can in turn cause muscle aches). However, if you think about it, your Achilles tendon (gastrocnemius and soleus group) are the hardest working muscles in your body, also the strongest. It only makes sense that they would hurt given the circumstances.