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Test ID: LEPDT Leptospira, IgM, Serum

Useful For

Aiding in the diagnosis of leptospirosis

 

This test is not useful for establishing cure or response to therapy.

Method Name

Enzyme-Linked Immunoassay Dot (Immunodot)

Reporting Name

Leptospira, IgM, S

Specimen Type

Serum


Specimen Required


Collection Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Submission Container/Tube: Plastic vial

Specimen Volume: 0.3 mL

Collection Instructions: Centrifuge and aliquot serum into plastic vial.

Additional Information: If acute and convalescent specimens are being obtained to determine seroconversion, they should be collected 2 or more weeks apart.


Specimen Minimum Volume

0.1 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Serum Refrigerated (preferred) 30 days
  Frozen  30 days

Clinical Information

Leptospirosis is a zoonotic disease of worldwide prevalence, though the majority of infections occur in warm, tropical climates. Wild mammals, typically rodents, are the primary, natural reservoir for disease-causing strains of Leptospira; however, domestic animals (eg, dogs) also represent a major source of human infection. Leptospira are gram-negative spirochetes with at least 20 different species in the genus. Of these, at least 9 species are considered disease-causing, including the most common agent of leptospirosis, Leptospira interrogans.

 

Transmission occurs through indirect human contact (eg, via mucous membranes or abraded skin) with water, food, or soil contaminated with animal urine containing the Leptospira spirochetes. Following infection, the incubation period can range from 3 to 30 days, depending on the inoculum dose and immune status of the individual.

 

The clinical manifestations of leptospirosis can vary, ranging from a mild, flu-like illness (eg, headache, malaise, fever, arthralgia, fatigue) to fulminant disease with severe liver and kidney involvement. The latter manifestation was previously referred to as Weil disease. Leptospira organisms may be found in the blood at the onset of disease and can persist for approximately 1 week. Subsequently, spirochetes may be found in the urine and can persist for 2 to 3 months; however, shedding may be intermittent and the number of organisms present may be low.

 

While Leptospira can be grown in culture, this is a fastidious organism that requires immediate transport to the laboratory. Additionally, detectable growth requires prolonged incubation (1-6 weeks), limiting the utility of culture for acute diagnosis. For this reason, serologic detection for antibodies to Leptospira remains the method of choice for rapid diagnosis. IgM-class antibodies to this spirochete are detectable by day 6 of illness and remain detectable for 2 to 3 months following symptom onset.

Reference Values

Negative

Interpretation

Positive:

IgM antibodies to Leptospira species detected, suggesting recent infection. Antibody presence alone cannot be used to definitively diagnose acute infection, as antibodies from a prior exposure or infection may remain detectable for a prolonged period.

 

Borderline:

Result should be interpreted with caution. Additional testing of a second, convalescent specimen is recommended. If the specimen remains borderline reactive, a second serological method should be considered if leptospirosis infection is still suspected.

 

Negative:

No IgM antibodies to Leptospira detected. Since antibodies may not be present or may be present at undetectable levels during early disease, repeat testing of a convalescent sample collected in 2 to 3 weeks is recommended.

Clinical Reference

1. Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Division of High-Consequence Pathogens and Pathology (DHCPP): Leptospriosis. Reviewed March 13, 2019. Accessed September 15, 2022. Available at www.cdc.gov/leptospirosis/

2. Costa F, Hagan JE, Calcagno J, et al: Global morbidity and mortality of Leptospirosis: a systemic review. PLoS Negl Trop Dis. 2015 Sept;9(9):e0003898. doi: 10.1371/journal.pntd.0003898

Day(s) Performed

Monday, Wednesday, Friday

Report Available

Same day/1 to 5 days

Test Classification

This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information

86720

LOINC Code Information

Test ID Test Order Name Order LOINC Value
LEPDT Leptospira, IgM, S 23201-7

 

Result ID Test Result Name Result LOINC Value
65183 Leptospira, IgM, S 23201-7

Forms

If not ordering electronically, complete, print, and send Infectious Disease Serology Test Request (T916) with the specimen.

Mayo Clinic Laboratories | Microbiology and Infectious Disease Catalog Additional Information:

mml-giinfections