Abstract
Leptospirosis remains an important infectious disease in the tropics. Interest in the disease in recent years has been focused on the pathophysiology and the changing patterns in certain geographical areas. Through direct invasion of leptospires, the outer membrane proteins interact with extracellular matrix causing colonization in the proximal tubules. Activation of TLR2 by LipL32 among outer membrane proteins release NFkB, mitogen-activated kinases and proinflammatory cytokines including TNFα, IL1, IL6 and IL8. Inflammatory reactions are generated. Hemodynamic changes in leptospirosis are essentially similar to those observed in sepsis characterized by decreased systemic vascular resistance, decreased blood pressure, increased cardiac output and increased renal vascular resistance. Kidney, liver and lung injuries are common.
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