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This systemic spirochetal infection, caused by Leptospira interrogans, is characterized primarily by hepatitis but may include an aseptic meningitis during the second part of a biphasic illness Initially there is high fever, tender muscles, chest and abdominal pain, and cough An extreme form (Weil disease) comprises hepatic and renal failure Prominent conjunctival suffusion and photophobia are typical of leptospirosis and should draw attention to the diagnosis The CSF during the meningitic stage contains approximately 100 lymphocytes per milliliter, but cell counts in excess of 10,000 have been reported and the protein concentration may reach high levels Subarachnoid and intracerebral bleeding, probably from in amed blood vessels, are known to occur The diagnosis is made by serologic methods (complement xation screening followed by speci c agglutination tests) Antibiotic treatment seems to be effective only if implemented during the initial febrile phase The meningitis is usually self-limited

This chapter is based on Treasury issues Corporate bonds respond in similar fashion only with the reactivity being reduced by the speed at which new corporate issues are sold with increased coupon rates or deeper discounts on zero coupon issues The hedge philosophy is the same for corporate, municipal, foreign government, and US Treasury issues The interest-rate contract specs we lay out show a signi cant number of contracts available for rate hedging from Eurodollars and LIBOR to foreign securities and US issues The option strategies we demonstrate offer many creative solutions for controlling interest-rate risk in your xed income portfolio Institutions favor credit swaps for hedging in many cases, but with the potential for regulation and basing OTC swaps on the exchanges for credit and credit default to help control the risk to the counter party, the OTC market may end up doing much the same in the future as the regulated side with the current futures

Figure 32-6 Encephalitis in Lyme disease High-signal areas in the white matter in a patient with Lyme disease arthritis (Reproduced by permission from Bisese JH: Cranial MRI New York, McGraw-Hill, 1991)

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