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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.
Revue Des Maladies Respiratoires
|October 7, 2003
Summary
Leptospirosis, a rare cause of alveolar hemorrhage, can be diagnosed through seroconversion even with initial negative tests. Prompt antibiotic treatment is crucial for recovery from severe complications like pneumonia and liver necrosis.
Area of Science:
- Infectious Diseases
- Pulmonary Medicine
- Hepatology
Background:
- Leptospirosis is an uncommon cause of alveolar hemorrhage.
- Delayed diagnosis is frequent with atypical infection routes.
- Prompt antibiotic intervention is vital for severe leptospirosis complications.
Observation:
- A 21-year-old male presented with pneumonia, hypoxemia, cholestasis, and liver necrosis after exposure to stagnant water.
- Broncho-alveolar lavage confirmed alveolar hemorrhage.
- Symptoms appeared 10 days post-exposure.
Findings:
- Initial serology (Martin and Petit) for leptospirosis was negative.
- Diagnosis was confirmed by seroconversion 20 days after symptom onset.
- The patient showed satisfactory resolution after antibiotic therapy.
Implications:
- Highlights the importance of considering leptospirosis in unexplained alveolar hemorrhage and liver dysfunction.
- Emphasizes that negative initial serology does not rule out leptospirosis.
- Underscores the effectiveness of timely antibiotic treatment in managing severe leptospirosis.