''Leptospira noguchii'' is a

gram-negative Gram-negative bacteria are bacteria that do not retain the crystal violet stain used in the Gram staining method of bacterial differentiation. They are characterized by their cell envelopes, which are composed of a thin peptidoglycan cell wall ...

pathogen In biology, a pathogen ( el, πάθος, "suffering", "passion" and , "producer of") in the oldest and broadest sense, is any organism or agent that can produce disease. A pathogen may also be referred to as an infectious agent, or simply a germ ...

ic organism named for Japanese bacteriologist Dr.

Hideyo Noguchi , also known as , was a prominent Japanese bacteriologist who in 1911 discovered the agent of syphilis as the cause of progressive paralytic disease. Early life Noguchi Hideyo whose childhood name was Seisaku Noguchi was born to a family of farme ...

who named the genus ''

Leptospira ''Leptospira'' ( grc, leptos, italics=yes, 'fine, thin' and la, spira, links=no, 'coil') is a genus of spirochaete bacteria, including a small number of pathogenic and saprophytic species. ''Leptospira'' was first observed in 1907 in kidney t ...

''.Zuerner, Richard L. "Leptospira." Bergey's Manual of Systemic Bacteriology. 2nd ed. Vol. 4th. Athens: Bergey's Manual Trust, 2010. 546-56. Print. ''L. noguchii'' is famous for causing the febrile illness in

Fort Bragg, NC Fort Bragg is a military installation of the United States Army in North Carolina, and is one of the largest military installations in the world by population, with around 54,000 military personnel. The military reservation is located within Cu ...

during

World War II World War II or the Second World War, often abbreviated as WWII or WW2, was a world war that lasted from 1939 to 1945. It involved the vast majority of the world's countries—including all of the great powers—forming two opposin ...

.Internal Medicine in World War II. Vol. II
Infectious Diseases
by Leonard D. Heaton; John Boyd Coates, Jr.; W. Paul Havens, Jr. There was 40 cases of this fever documented during each summer from 1942 to 1944; however, there were 0 deaths recorded from this outbreak. Unlike other strains of ''Leptospira'' that cause

leptospirosis Leptospirosis is a blood infection caused by the bacteria ''Leptospira''. Signs and symptoms can range from none to mild (headaches, muscle pains, and fevers) to severe ( bleeding in the lungs or meningitis). Weil's disease, the acute, severe ...

, ''L. noguchii'' is characterized by showing
pretibial rash
on the victim. Its specific epithet recognises

Background

Discovery

''Leptospira noguchii'' was originally cultured in 1907, but was thought to be '' Spirochaeta interrogans'' due to the question mark shape of the cell.Yasuda, P. H., A. G. Steigerwalt, K. R. Sulzer, A. F. Kaufmann, F. Rogers, and D. J. Brenner.
Deoxyribonucleic Acid Relatedness between Serogroups and Serovars in the Family Leptospiraceae with Proposals for Seven New Leptospira Species.
''International Journal of Systematic Bacteriology'' 37.4 (1987): 407-15. Web. 15 Feb. 2016. However, upon further research on the

16s rRNA 16S rRNA may refer to: * 16S ribosomal RNA 16 S ribosomal RNA (or 16 S rRNA) is the RNA component of the 30S subunit of a prokaryotic ribosome ( SSU rRNA). It binds to the Shine-Dalgarno sequence and provides most of the SSU structure. The g ...

Yasuda ''et al.'' was able to classify this organism as ''Leptospira'' ''noguchii.''

Phylogeny

Originally, there were only two species classifications of ''Leptospira.''Spickler AR, Leedom Larson KR
Leptospirosis
August 2013. At They were categorized as ''

Leptospira interrogans ''Leptospira interrogans'' is a species of obligate aerobic spirochaete bacteria shaped like a corkscrew with hooked and spiral ends. ''L. interrogans'' is mainly found in warmer tropical regions. The bacteria can live for weeks to months in the gr ...

'', the pathogenic species, and ''

Leptospira biflexa ''Leptospira biflexa'' is a spirochaete bacterium in the genus ''Leptospira'' and was the first saprophytic Leptospira genome to be sequenced. Morphology and physiology ''Leptospira biflexa'' are a helix shaped bacterium containing periplasmic ...

'', the nonpathogenic species. However, in 1989, it was discovered that there were 21 different

species In biology, a species is the basic unit of classification and a taxonomic rank of an organism, as well as a unit of biodiversity. A species is often defined as the largest group of organisms in which any two individuals of the appropriate s ...

of ''Leptospira.'' Within these 21 species, ''Leptospira noguchii'' was recognized. However,

conjugation Conjugation or conjugate may refer to: Linguistics * Grammatical conjugation, the modification of a verb from its basic form * Emotive conjugation or Russell's conjugation, the use of loaded language Mathematics * Complex conjugation, the chang ...

is very common among the genetic materials making them hard to distinguish individual species.

Ecology

''Leptospira noguchii'' can grow in stagnant water, and is known to grow optimally between 28 °C - 30 °C at a pH between 7.2 and 7.6. ''L. noguchii'' is also known to have a

parasitic Parasitism is a close relationship between species, where one organism, the parasite, lives on or inside another organism, the host, causing it some harm, and is adapted structurally to this way of life. The entomologist E. O. Wilson has c ...

relationship and grow in host's

kidney The kidneys are two reddish-brown bean-shaped organs found in vertebrates. They are located on the left and right in the retroperitoneal space, and in adult humans are about in length. They receive blood from the paired renal arteries; blood ...

s. It can be isolated from

urine Urine is a liquid by-product of metabolism in humans and in many other animals. Urine flows from the kidneys through the ureters to the urinary bladder. Urination results in urine being excretion, excreted from the body through the urethra. Cel ...

blood Blood is a body fluid in the circulatory system of humans and other vertebrates that delivers necessary substances such as nutrients and oxygen to the cells, and transports metabolic waste products away from those same cells. Blood in the c ...

, and

cerebrospinal fluid Cerebrospinal fluid (CSF) is a clear, colorless body fluid found within the tissue that surrounds the brain and spinal cord of all vertebrates. CSF is produced by specialised ependymal cells in the choroid plexus of the ventricles of the bra ...

Characteristics

''Leptospira noguchii'' are

spirochete A spirochaete () or spirochete is a member of the phylum Spirochaetota (), (synonym Spirochaetes) which contains distinctive diderm (double-membrane) gram-negative bacteria, most of which have long, helically coiled (corkscrew-shaped or s ...

-shaped, gram-negative bacterium that typically range from 0.1 μm by 6 μm to 0.1 μm to 20 μm.Johnson, Russell C.
Medical Microbiology 4th Edition
" ''Leptospira''. U.S. National Library of Medicine, n.d. Web. 07 Mar. 2016. ''Leptospira noguchii'' also lacks

glycolipid Glycolipids are lipids with a carbohydrate attached by a glycosidic (covalent) bond. Their role is to maintain the stability of the cell membrane and to facilitate cellular recognition, which is crucial to the immune response and in the connec ...

s in their

peptidoglycan Peptidoglycan or murein is a unique large macromolecule, a polysaccharide, consisting of sugars and amino acids that forms a mesh-like peptidoglycan layer outside the plasma membrane, the rigid cell wall (murein sacculus) characteristic of most ...

and contain

diaminopimelic acid Diaminopimelic acid (DAP) is an amino acid, representing an epsilon-carboxy derivative of lysine. DAP is a characteristic of certain cell walls of some bacteria. DAP is often found in the peptide linkages of NAM-NAG chains that make up the ce ...

. ''L. noguchii'' is a motile organism due to having

amphitrichous A flagellum (; ) is a hairlike appendage that protrudes from certain plant and animal sperm cells, and from a wide range of microorganisms to provide motility. Many protists with flagella are termed as flagellates. A microorganism may have fro ...

flagella on opposing ends of each other.Adler, Ben, ed.
Leptospira and Leptospirosis
'. N.p.: Springer, 2015. Print. ''Leptospira'' organisms can be cultured i

medium at 30 °C.Johnson RC, Harris VG (1967)
"Differentiation of Pathogenic and Saprophytic Leptospires I. Growth at Low Temperatures"
''J. Bacteriol.'' 94 (1): 27–31. PMCbr>251866

PMID PubMed is a free search engine accessing primarily the MEDLINE database of references and abstracts on life sciences and biomedical topics. The United States National Library of Medicine (NLM) at the National Institutes of Health maintain the ...

br>6027998
Due to ''Leptospira’s'' morphology, researchers typically use

dark-field microscopy Dark-field microscopy (also called dark-ground microscopy) describes microscopy methods, in both light and electron microscopy, which exclude the unscattered beam from the image. As a result, the field around the specimen (i.e., where there is ...

as opposed to Light-field microscopy because the amphitrichous flagella produce quick movements along the

microscope A microscope () is a laboratory instrument used to examine objects that are too small to be seen by the naked eye. Microscopy is the science of investigating small objects and structures using a microscope. Microscopic means being invisibl ...

that are hard to see on a light-field microscope.

Metabolism

''Leptospira'' ''noguchii'' is a

chemoorganotroph Primary nutritional groups are groups of organisms, divided in relation to the nutrition mode according to the sources of energy and carbon, needed for living, growth and reproduction. The sources of energy can be light or chemical compounds; the ...

ic organism. The

metabolism Metabolism (, from el, μεταβολή ''metabolē'', "change") is the set of life-sustaining chemical reactions in organisms. The three main functions of metabolism are: the conversion of the energy in food to energy available to run cell ...

of ''L. noguchii'' is unusual due to the fact that the main source of energy and

carbon Carbon () is a chemical element with the symbol C and atomic number 6. It is nonmetallic and tetravalent In chemistry, the valence (US spelling) or valency (British spelling) of an element is the measure of its combining capacity with o ...

comes from

beta-oxidation In biochemistry and metabolism, beta-oxidation is the catabolic process by which fatty acid molecules are broken down in the cytosol in prokaryotes and in the mitochondria in eukaryotes to generate acetyl-CoA, which enters the citric acid cycle, ...

of long-chained

fatty acid In chemistry, particularly in biochemistry, a fatty acid is a carboxylic acid with an aliphatic chain, which is either saturated or unsaturated. Most naturally occurring fatty acids have an unbranched chain of an even number of carbon atoms, fr ...

s. An interesting fact about ''Leptospira'' ''noguchii'' is that it the ability to process

glucose Glucose is a simple sugar with the molecular formula . Glucose is overall the most abundant monosaccharide, a subcategory of carbohydrates. Glucose is mainly made by plants and most algae during photosynthesis from water and carbon dioxide, using ...

; however, this is not its preferred way to obtain energy, though it has the necessary

enzyme Enzymes () are proteins that act as biological catalysts by accelerating chemical reactions. The molecules upon which enzymes may act are called substrates, and the enzyme converts the substrates into different molecules known as products. A ...

s to perform this process. This organism is also able to use the respiratory

electron transport chain An electron transport chain (ETC) is a series of protein complexes and other molecules that transfer electrons from electron donors to electron acceptors via redox reactions (both reduction and oxidation occurring simultaneously) and couples th ...

due to being an

aerobic organism Aerobic means "requiring air," in which "air" usually means oxygen. Aerobic may also refer to * Aerobic exercise, prolonged exercise of moderate intensity * Aerobics, a form of aerobic exercise * Aerobic respiration, the aerobic process of cell ...

that can also survive in

microaerophilic A microaerophile is a microorganism that requires environments containing lower levels of dioxygen than that are present in the atmosphere (i.e. < 21% O₂; typically 2–10% O₂) for optimal growth. A more re ...

environments. The characteristic of being aerobic allows this organism to perform

oxidative phosphorylation Oxidative phosphorylation (UK , US ) or electron transport-linked phosphorylation or terminal oxidation is the metabolic pathway in which cells use enzymes to oxidize nutrients, thereby releasing chemical energy in order to produce adenosine tri ...

in order to produce ATP for energy.

Genomics

''Leptospira noguchii'' has a low

GC content In molecular biology and genetics, GC-content (or guanine-cytosine content) is the percentage of nitrogenous bases in a DNA or RNA molecule that are either guanine (G) or cytosine (C). This measure indicates the proportion of G and C bases out o ...

of 35.63% while the

genome size Genome size is the total amount of DNA contained within one copy of a single complete genome. It is typically measured in terms of mass in picograms (trillionths (10−12) of a gram, abbreviated pg) or less frequently in daltons, or as the total ...

is 4.76 Mbp.Moreno, Luisa Z., Ana P. Loureiro, Fabiana Miraglia, Carlos E. C. Matajira, Frederico S. Kremer, Marcos R. Eslabao, Odir A. Dellagostin, Walter Lilenbaum, and Andrea M. Moreno.
Draft Genome Sequence of Brazilian Leptospira Noguchii Serogroup Panama Strain U73, Isolated from Cattle
" ''Genome Announcements Genome Announc.'' 3.5 (2015): n. pag. Web. 15 Feb. 2016. The sequencing of the genome was accomplished using BASys, which is bacterial annotation system. There are a total of 4,535

coding sequence The coding region of a gene, also known as the coding sequence (CDS), is the portion of a gene's DNA or RNA that codes for protein. Studying the length, composition, regulation, splicing, structures, and functions of coding regions compared to no ...

s within ''L. noguchii's'' genome that have been identified.

Fort Bragg, North Carolina outbreak

In the summer of 1942, Fort Bragg, NC endured an outbreak of a sickness which presented with

malaise As a medical term, malaise is a feeling of general discomfort, uneasiness or lack of wellbeing and often the first sign of an infection or other disease. The word has existed in French since at least the 12th century. The term is often used ...

, general aches and pains, headaches, and post- orbital pains.Daniels, Worth B., M.D.
Office of Medical History.
''Office of Medical History''. U.S. Army Dept. of Medical History, 01 June 2009. Web. 25 Apr. 2016. 40 patients came in with these similar symptoms. Upon obtaining information about their recent actions, locations, and

barracks Barracks are usually a group of long buildings built to house military personnel or laborers. The English word originates from the 17th century via French and Italian from an old Spanish word "barraca" ("soldier's tent"), but today barracks are u ...

, most patients said that they recently swam in lakes close to the Fort Bragg military complex. In about 95% of the patients presented with

Splenomegaly Splenomegaly is an enlargement of the spleen. The spleen usually lies in the left upper quadrant (LUQ) of the human abdomen. Splenomegaly is one of the four cardinal signs of ''hypersplenism'' which include: some reduction in number of circulating ...

in the early stages, and then on the fourth day a pretibial rash presented in most of the patients. While the patients were recovering, the doctors taking care of the soldier were stumped by the

after the differential diagnosis. The doctors requested the Surgeon General was petitioned by the

U.S. army The United States Army (USA) is the land service branch of the United States Armed Forces. It is one of the eight U.S. uniformed services, and is designated as the Army of the United States in the U.S. Constitution.Article II, section 2, cl ...

to send others to help research the unidentified pathogen. Dr. Norman H. Topping, Maj. Cornelius B. Phillips, and Dr. John R. Paul all were sent to investigate the pathogen. They concluded that the pathogen was water-borne and not transferred by any kind of

insect Insects (from Latin ') are pancrustacean hexapod invertebrates of the class Insecta. They are the largest group within the arthropod phylum. Insects have a chitinous exoskeleton, a three-part body ( head, thorax and abdomen), three pairs ...

. In 1944, Capt. Hugh Tatlock finally completed a transfer of the pathogen to a

mammal Mammals () are a group of vertebrate animals constituting the class Mammalia (), characterized by the presence of mammary glands which in females produce milk for feeding (nursing) their young, a neocortex (a region of the brain), fur or ...

, causing them to figure out that the pathogen is only transferable between mammals. In 1945, Capt. Tatlock finally thought he classified the pathogen as a

virus A virus is a submicroscopic infectious agent that replicates only inside the living cells of an organism. Viruses infect all life forms, from animals and plants to microorganisms, including bacteria and archaea. Since Dmitri Ivanovsky's 1 ...

. Later, in 1951, when the necessary technology became available to perform

agglutination In linguistics, agglutination is a morphological process in which words are formed by stringing together morphemes, each of which corresponds to a single syntactic feature. Languages that use agglutination widely are called agglutinative lang ...

tests and cross-reference agglutination tests, they found that it was a species of the genus ''Leptospira''. At the time, the pathogen was thought to be called ''Leptospira Autumnalis'', but upon further study of the whole-genome, it was later reclassified as a

serovar A serotype or serovar is a distinct variation within a species of bacteria or virus or among immune cells of different individuals. These microorganisms, viruses, or cells are classified together based on their surface antigens, allowing the epi ...

of ''Leptospira noguchii''. This Leptospirosis became known as “ Fort Bragg Fever.”Silva, Éverton F. et al. “
Leptospira Noguchii

and Human and Animal Leptospirosis, Southern Brazil
” ''Emerging Infectious Diseases'' 15.4 (2009): 621–623. ''PMC''. Web. 16 Feb. 2016.

Isolation of main pathogenic strains

Bonito Strain

The Bonito strain of ''L. noguchii'' was isolated from a 34-year-old man in Brazil that was suffering from Leptospirosis. The man is suspected to have contracted this disease through interaction with rats, dogs, and other farm animals. The man was taken to the

Hospital A hospital is a health care institution providing patient treatment with specialized health science and auxiliary healthcare staff and medical equipment. The best-known type of hospital is the general hospital, which typically has an emerge ...

Santa Casa de Misericórdia, Pelotas, and his lab results showed an elevated

bilirubin Bilirubin (BR) (Latin for "red bile") is a red-orange compound that occurs in the normal catabolic pathway that breaks down heme in vertebrates. This catabolism is a necessary process in the body's clearance of waste products that arise from the ...

level. This strain was able to be isolated from a

blood culture A blood culture is a medical laboratory test used to detect bacteria or fungi in a person's blood. Under normal conditions, the blood does not contain microorganisms: their presence can indicate a bloodstream infection such as bacteremia or f ...

at the hospital.

Cascata Strain

This strain was initially obtained form a 16-year-old boy in

Brazil Brazil ( pt, Brasil; ), officially the Federative Republic of Brazil (Portuguese: ), is the largest country in both South America and Latin America. At and with over 217 million people, Brazil is the world's fifth-largest country by area ...

via a blood culture. This patient also reported being around rats and dogs; however, he was not hospitalized for his illness.

Hook Strain

This strain was isolated from a dog found in Brazil that appeared to be suffering from

anorexia Anorexia nervosa, often referred to simply as anorexia, is an eating disorder characterized by low weight, food restriction, body image disturbance, fear of gaining weight, and an overpowering desire to be thin. ''Anorexia'' is a term of Gre ...

. The dog died form this strain of ''L. noguchii'', and the symptoms present were slightly different than when humans were infected. The dog presented with

disorientation Orientation is a function of the mind involving awareness of three dimensions: time, Location (geography), place and person. Problems with orientation lead to ''dis''orientation, and can be due to various conditions, from delirium to Substance int ...

, diarrhea, vomiting, anorexia, and

lethargy Lethargy is a state of tiredness, sleepiness, weariness, fatigue, sluggishness or lack of energy. It can be accompanied by depression, decreased motivation, or apathy. Lethargy can be a normal response to inadequate sleep, overexertion, overwo ...

. The Hook strain was isolated from the kidney tissue, as this is where ''L. noguchii'' typically resides in its host.

Pathogenesis

''Leptospira noguchii'' is another

ic bacteria that causes

Leptospirosis Leptospirosis is a blood infection caused by the bacteria ''Leptospira''. Signs and symptoms can range from none to mild (headaches, muscle pains, and fevers) to severe ( bleeding in the lungs or meningitis). Weil's disease, the acute, severe ...

. Leptospirosis can be transferred in a multitude of ways. Leptospirosis can transfer from animals to humans (

zoonosis A zoonosis (; plural zoonoses) or zoonotic disease is an infectious disease of humans caused by a pathogen (an infectious agent, such as a bacterium, virus, parasite or prion) that has jumped from a non-human (usually a vertebrate) to a human. ...

), humans to humans, or animals to animals via intake of contaminated body fluids, such as urine and blood. The disease is normally absorbed through the

mucous membrane A mucous membrane or mucosa is a membrane that lines various cavities in the body of an organism and covers the surface of internal organs. It consists of one or more layers of epithelial cells overlying a layer of loose connective tissue. It is ...

s of another animal or human and is excreted from the body in the urine. The infected individual can be

asymptomatic In medicine, any disease is classified asymptomatic if a patient tests as carrier for a disease or infection but experiences no symptoms. Whenever a medical condition fails to show noticeable symptoms after a diagnosis it might be considered asy ...

or have very severe symptoms. In serious cases, kidney or liver failure,

aseptic meningitis Aseptic meningitis is the inflammation of the meninges, a membrane covering the brain and spinal cord, in patients whose cerebral spinal fluid test result is negative with routine bacterial cultures. Aseptic meningitis is caused by viruses, myco ...

, and fatal pulmonary hemorrhages have occurred in humans.

Entry

As it enters through the

s or abrasions on the skin, its travels in your bloodstream to your kidney's renal tubing, where it stays an enters the

incubation period Incubation period (also known as the latent period or latency period) is the time elapsed between exposure to a pathogenic organism, a chemical, or radiation, and when symptoms and signs are first apparent. In a typical infectious disease, the i ...

. A unique adaptation of ''Leptospira noguchii'' is that it can complete translational movement in thick liquids, giving it the ability to penetrate deep tissue.

Attachment

''Leptospira noguchii'' attaches in the

urinary tract The urinary system, also known as the urinary tract or renal system, consists of the kidneys, ureters, bladder, and the urethra. The purpose of the urinary system is to eliminate waste from the body, regulate blood volume and blood pressure, con ...

through the use of

immunoglobulin An antibody (Ab), also known as an immunoglobulin (Ig), is a large, Y-shaped protein used by the immune system to identify and neutralize foreign objects such as pathogenic bacteria and viruses. The antibody recognizes a unique molecule of the ...

-like proteins

LigA Liga or LIGA may refer to: People * Līga (name), a Latvian female given name * Luciano Ligabue, more commonly known as Ligabue or ''Liga'', Italian rock singer-songwriter Sports * Liga ACB, men's professional basketball league in Spain * Liga ...

and LigB, endostain-like proteins, and the

membrane protein Membrane proteins are common proteins that are part of, or interact with, biological membranes. Membrane proteins fall into several broad categories depending on their location. Integral membrane proteins are a permanent part of a cell membrane ...

LipL32.

Virulence Factors

Pathogenic ''Leptospira'' spp. has features of both a gram-positive and gram-negative pathogen. Features of the gram-negative pathogen is the presences of

lipopolysaccharide Lipopolysaccharides (LPS) are large molecules consisting of a lipid and a polysaccharide that are bacterial toxins. They are composed of an O-antigen, an outer core, and an inner core all joined by a covalent bond, and are found in the outer m ...

s (LPS), but the closeness of the

cytoplasmic membrane The cell membrane (also known as the plasma membrane (PM) or cytoplasmic membrane, and historically referred to as the plasmalemma) is a biological membrane that separates and protects the interior of all cells from the outside environment ( ...

to the cell wall shows more of a gram-positive feature. Also, the virulence factors on the flagella of pathogenic leptospires have thought to be involved in the overall infection''.'' ''Leptospira noguchii'' specifically creates a

median lethal dose In toxicology, the median lethal dose, LD50 (abbreviation for "lethal dose, 50%"), LC50 (lethal concentration, 50%) or LCt50 is a toxic unit that measures the lethal dose of a toxin, radiation, or pathogen. The value of LD50 for a substance is the ...

(LD₅₀) of three to 100 leptospires. ''L. noguchii'' also uses the Lsa24 protein to avoid the

immune system The immune system is a network of biological processes that protects an organism from diseases. It detects and responds to a wide variety of pathogens, from viruses to parasitic worms, as well as cancer cells and objects such as wood splinte ...

of the host and

antibacterials An antibiotic is a type of antimicrobial substance active against bacteria. It is the most important type of antibacterial agent for fighting bacterial infections, and antibiotic medications are widely used in the treatment and prevention of ...

by binding to

factor H Factor H is a member of the regulators of complement activation family and is a complement control protein. It is a large (155 kilodaltons), soluble glycoprotein that circulates in human plasma (at typical concentrations of 200–300 micrograms ...

. While the most important

virulence factor Virulence factors (preferably known as pathogenicity factors or effectors in plant science) are cellular structures, molecules and regulatory systems that enable microbial pathogens (bacteria, viruses, fungi, and protozoa) to achieve the following ...

has not yet been identified, some of the other proteins that are considered to be contributors to the main virulence are

hemolysin Hemolysins or haemolysins are lipids and proteins that cause lysis of red blood cells by disrupting the cell membrane. Although the lytic activity of some microbe-derived hemolysins on red blood cells may be of great importance for nutrient acqu ...

s, more specifically

phospholipase C Phospholipase C (PLC) is a class of membrane-associated enzymes that cleave phospholipids just before the phosphate group (see figure). It is most commonly taken to be synonymous with the human forms of this enzyme, which play an important role ...

, sphingomylinase-like proteins, and pore-forming proteins.

Symptoms

The disease typically begins with fever, and will then lead to other symptoms. The symptoms in humans include: High fever (102 °F-104 °F), headache, chills, muscle aches, vomiting,

jaundice Jaundice, also known as icterus, is a yellowish or greenish pigmentation of the skin and sclera due to high bilirubin levels. Jaundice in adults is typically a sign indicating the presence of underlying diseases involving abnormal heme meta ...

conjunctivitis Conjunctivitis, also known as pink eye, is inflammation of the conjunctiva, outermost layer of the white part of the eye and the inner surface of the eyelid. It makes the eye appear pink or reddish. Pain, burning, scratchiness, or itchiness may ...

, abdominal pain, diarrhea, and a pretibial rash.Leptospirosis
" Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 18 Nov. 2014. Web. 11 Apr. 2016. Some complications are

Weil's syndrome Leptospirosis is a blood infection caused by the bacteria '' Leptospira''. Signs and symptoms can range from none to mild (headaches, muscle pains, and fevers) to severe ( bleeding in the lungs or meningitis). Weil's disease, the acute, sever ...

which is a multi-system organ complication causing jaundice,

meningitis Meningitis is acute or chronic inflammation of the protective membranes covering the brain and spinal cord, collectively called the meninges. The most common symptoms are fever, headache, and neck stiffness. Other symptoms include confusion or ...

pulmonary hemorrhage Pulmonary hemorrhage (or pulmonary haemorrhage) is an acute bleeding from the lung, from the upper respiratory tract and the trachea, and the pulmonary alveoli. When evident clinically, the condition is usually massive.hepatic The liver is a major organ only found in vertebrates which performs many essential biological functions such as detoxification of the organism, and the synthesis of proteins and biochemicals necessary for digestion and growth. In humans, it i ...

and

renal The kidneys are two reddish-brown bean-shaped organs found in vertebrates. They are located on the left and right in the retroperitoneal space, and in adult humans are about in length. They receive blood from the paired renal arteries; blood ...

dysfunction, and

cardiovascular collapse Shock is the state of insufficient blood flow to the tissues of the body as a result of problems with the circulatory system. Initial symptoms of shock may include weakness, fast heart rate, fast breathing, sweating, anxiety, and increased thi ...

.Evangelista, Karen V, and Jenifer Coburn. “
Leptospira

as an Emerging Pathogen: A Review of Its Biology, Pathogenesis and Host Immune Responses.
�� ''Future microbiology'' 5.9 (2010): 1413–1425. ''PMC''. Web. 25 Apr. 2016.

Treatment

''Leptospira noguchii'' is very sensitive to a large number of

antibiotics An antibiotic is a type of antimicrobial substance active against bacteria. It is the most important type of antibacterial agent for fighting bacterial infections, and antibiotic medications are widely used in the treatment and prevention o ...

. The common antibiotics used are:

Beta-lactams A beta-lactam (β-lactam) ring is a four-membered lactam. A ''lactam'' is a cyclic amide, and ''beta''-lactams are named so because the nitrogen atom is attached to the β-carbon atom relative to the carbonyl. The simplest β-lactam possible is ...

(

penicillin Penicillins (P, PCN or PEN) are a group of β-lactam antibiotics originally obtained from ''Penicillium'' moulds, principally '' P. chrysogenum'' and '' P. rubens''. Most penicillins in clinical use are synthesised by P. chrysogenum using ...

ampicillin Ampicillin is an antibiotic used to prevent and treat a number of bacterial infections, such as respiratory tract infections, urinary tract infections, meningitis, salmonellosis, and endocarditis. It may also be used to prevent group B strepto ...

, and

amoxycillin Amoxicillin is an antibiotic medication used to treat a number of bacterial infections. These include middle ear infection, strep throat, pneumonia, skin infections, and urinary tract infections among others. It is taken by mouth, or less co ...

Rifampin Rifampicin, also known as rifampin, is an ansamycin antibiotic used to treat several types of bacterial infections, including tuberculosis (TB), ''Mycobacterium avium'' complex, leprosy, and Legionnaires’ disease. It is almost always used tog ...

Tetracycline Tetracycline, sold under various brand names, is an oral antibiotic in the tetracyclines family of medications, used to treat a number of infections, including Acne vulgaris, acne, cholera, brucellosis, plague (disease), plague, malaria, and sy ...

Doxycycline Doxycycline is a broad-spectrum tetracycline class antibiotic used in the treatment of infections caused by bacteria and certain parasites. It is used to treat bacterial pneumonia, acne, chlamydia infections, Lyme disease, cholera, typhus, an ...

Cephalosporin The cephalosporins (sg. ) are a class of β-lactam antibiotics originally derived from the fungus ''Acremonium'', which was previously known as ''Cephalosporium''. Together with cephamycins, they constitute a subgroup of β-lactam antibiotics ...

Aminoglycoside Aminoglycoside is a medicinal and bacteriologic category of traditional Gram-negative antibacterial medications that inhibit protein synthesis and contain as a portion of the molecule an amino-modified glycoside (sugar). The term can also refer ...

Macrolide The Macrolides are a class of natural products that consist of a large macrocyclic lactone ring to which one or more deoxy sugars, usually cladinose and desosamine, may be attached. The lactone rings are usually 14-, 15-, or 16-membered. Macrol ...

s (

erythromycin Erythromycin is an antibiotic used for the treatment of a number of bacterial infections. This includes respiratory tract infections, skin infections, chlamydia infections, pelvic inflammatory disease, and syphilis. It may also be used duri ...

and

Azithromycin Azithromycin, sold under the brand names Zithromax (in oral form) and Azasite (as an eye drop), is an antibiotic medication used for the treatment of a number of bacterial infections. This includes middle ear infections, strep throat, pneumon ...

), and

Fluoroquinolones A quinolone antibiotic is a member of a large group of broad-spectrum antibiotic, broad-spectrum bacteriocidals that share a bicyclic molecule, bicyclic core structure related to the substance 4-Quinolone, 4-quinolone. They are used in human and ...

References

External links

Type strain of ''Leptospira noguchii'' at Bac''Dive'' - the Bacterial Diversity Metadatabase
{{Taxonbar, from=Q16984416 noguchii Bacteria described in 1987