Characteristics of long-term benzodiazepine users.

remembered that he had been bitten on the hand by a mouse which he had rescued from his pet cat. A provisional diagnosis of leptospirosis was made and the patient was treated with intravenous ampicillin 6 g daily in divided doses. He made a good clinical recovery and returned to West Germany after 10 days. His liver function tests returned to normal over the following two months. Initial serological examination performed in Italy and subsequent examinations performed during convalescence confirmed infection with Leptospira interrogans (grippotyphosa variety). Leptospirosis transmitted by rodent bites has been previously described, and is an unusual mode of transmission."2 The mechanism is unclear as leptospires have not been found in rodent saliva, but it is probable that contamination of the fresh wound by urine occurs. It has been suggested that this may result from urine being present in the animal's fur as a result of preening, or else may occur as a result of the animal spraying urine in fright.' L. interrogans (grippotyphosa variety) is endemic in small rodents in central Europe, the major host being the common vole (Microtus arvalis).3 In Czechoslo-vakia up to 12% of abattoir workers and 11% of agricultural workers have been shown to be positive for leptospiral anti-bodies, L. grippotyphosa being the second commonest serovar.4 Epizootics occur in rodents and these may be related to outbreaks of disease in humans. Principally affected are those in contact with small animals, particularly in wet and damp conditions.5 This is highlighted by the synonyms for the disease, such as swamp fever, mud fever, slime fever, field fever or the German schlammfieber. Clinically the disease is usually a mild one typified by sudden onset of chills and rigors, resembling influenza. Myalgia is characteristic. Jaundice and renal failure are rare, with the illness normally lasting seven to 10 days. Mortality is less than 1%.4 L. interrogans (grippotyphosa variety) is diagnosed infrequently in the British Isles.6'7 Although our patient was diagnosed and treated abroad, he had travelled a significant distance between exposure and subsequent illness, and could easily have presented in the United Kingdom. With increasing tourist traffic to endemic areas, particularly of campers and backpackers, this disease should be included in the differential diagnosis of the febrile traveller. We thank Dr S A Watkins of the PHLS Lep-tospira Reference Unit, Hereford, and the In-stituzione mallattiae Reparto Infettive del ospetale Santissimo Tihnita for their help in investigation , …