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[Pulmonary compromise in leptospirosis].
J E de Carvalho1, E dos S Marchiori, J B Guedes e Silva
1Hospital Universitário Antônio Pedro, Niterói, RJ.
Revista Da Sociedade Brasileira De Medicina Tropical
|January 1, 1992
Summary
Pulmonary complications in leptospirosis frequently involve bleeding and abnormal lung imaging. Post-mortem analysis revealed lung damage consistent with acute respiratory distress syndrome and disseminated intravascular coagulation.
Area of Science:
- Infectious Diseases
- Pulmonology
- Pathology
Background:
- Leptospirosis is a zoonotic disease with potential for severe systemic manifestations.
- Pulmonary involvement is a critical complication of severe leptospirosis.
- Understanding the spectrum of pulmonary complications is crucial for patient management.
Purpose of the Study:
- To investigate the pulmonary complications in patients diagnosed with leptospirosis.
- To characterize radiological and pathological findings in the lungs of leptospirosis patients.
Main Methods:
- Retrospective review of 23 leptospirosis case records.
- Analysis of clinical data, arterial blood gas measurements, and thoracic radiology findings.
- Examination of lung pathology in 13 necropsy cases.
Main Results:
- Hemoptysis (21.7%) and blood in sputum (30.4%) were common.
- Hypoxemia and hypocapnia were prevalent based on arterial gasometry.
- Radiology showed alveolar (60%) and alveolo-interstitial (20%) patterns.
- Necropsy revealed edema, congestion, and hemorrhage in all cases.
- Hyaline membranes (30%) and fibrin thrombi (46%) indicated severe lung injury.
Conclusions:
- Leptospirosis frequently causes significant pulmonary complications.
- Findings suggest high rates of adult respiratory distress syndrome and acute disseminated intravascular coagulation in severe cases.
- Pulmonary hemorrhage and edema are key pathological features.