Open AccessSevere pulmonary haemorrhage accompanying hepatorenal failure in fulminant leptospirosis
Author(s) -
Dursun B.,
Bostan F.,
Artac M.,
Varan H. I.,
Suleymanlar G.
Publication year - 2007
Publication title -
international journal of clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.756
H-Index - 98
eISSN - 1742-1241
pISSN - 1368-5031
DOI - 10.1111/j.1742-1241.2006.00638.x
Subject(s) - medicine , leptospirosis , fulminant , subclinical infection , intensive care medicine , multiorgan failure , fulminant hepatic failure , respiratory failure , hepatorenal syndrome , pathology , liver transplantation , ascites , transplantation
Summary Leptospirosis is a re‐emerging spirochetal zoonosis with a worldwide distribution affecting both animals and humans. The clinical syndromes may vary from a subclinical infection to a severe illness. Although it may potentially have a fulminant and fatal course, leptospirosis usually remains as an underdiagnosed cause of multiorgan failure. In this study, we report a patient with leptospirosis who presented with a fulminant course of diffuse alveolar haemorrhage and hepatorenal failure. His clinical condition deteriorated, despite appropriate antibiotic therapy and haemodialysis. However, he showed prompt clinical improvement when corticosteroids and plasma exchange were instituted in addition to the original therapy. We conclude that leptospirosis should be considered in any case presenting with pulmonary haemorrhage and hepatorenal failure. Plasma exchange and corticosteroids may be a choice of treatment in selected patients unresponsive to conventional therapy. Potential benefits of plasma exchange and corticosteroids may be based on a toxin‐ and/or cytokine‐mediated pathogenesis of the disease.