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["Post traumatic" leptospirosis complicated by acute respiratory insufficiency]
J Clarissou1, J-F le Calvez, L Desbouchages
1Service de Réanimation Médico-Chirurgicale, Hôpital André Mignot, CH Versailles, Le Chesnay, France.
Introduction:
Leptospirosis is a rare cause of alveolar haemorrhage. The diagnosis is often delayed particularly when the mode of infection is atypical. These serious complications require prompt antibiotic treatment.
Case Report:
A 21-year-old man was involved in a road accident and found lying unconscious in a roadside ditch containing stagnant water. Ten days later he presented with bilateral interstitial pneumonia and rapidly increasing hypoxaemia associated with cholestasis and liver cell necrosis. Broncho-alveolar lavage revealed alveolar haemorrhage. There was satisfactory resolution following antibiotic therapy.
Conclusions:
The diagnosis of leptospirosis was considered initially despite negative serology (Martin and Petit) and confirmed by sero-conversion 20 days after the onset of symptoms.