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[Weil's syndrome with bone marrow involvement after collecting walnuts]
M Wenz1, B Gorissen, S Wieshammer
1Medizinische Klinik I, Klinikum Offenburg. Dr.Wenz@t-online.de
Deutsche Medizinische Wochenschrift (1946)
|October 12, 2001
Summary
Severe leptospirosis, known as Weil's syndrome, can present with kidney failure, jaundice, and low platelets. Early antibiotic treatment is crucial for recovery, as demonstrated in this case report.
Area of Science:
- Infectious Diseases
- Nephrology
- Hematology
Background:
- Leptospirosis is a zoonotic infection with a wide spectrum of clinical manifestations.
- Weil's syndrome represents the most severe form of leptospirosis, characterized by jaundice, hemorrhage, and acute kidney injury.
Observation:
- A 65-year-old man presented with anuria, epistaxis, jaundice, and petechiae.
- He reported recent exposure to wild walnuts from a rat-infested area.
- Initial investigations revealed thrombocytopenia, hyperbilirubinemia, elevated urine retention parameters, and high C-reactive protein.
Findings:
- The patient was diagnosed with acute leptospiral infection manifesting as Weil's syndrome.
- Elevated serum leptospiral antibody titers confirmed the diagnosis.
- Silver staining of bone marrow revealed rod-shaped bacteria consistent with leptospires.
Implications:
- Prompt recognition of Weil's syndrome is critical for timely intervention.
- Intravenous penicillin and fluid resuscitation were effective in managing the severe leptospirosis case.
- Early antibiotic treatment can prevent the need for dialysis and lead to a full recovery.