[Irreversible sequels of leptospirosis]

Leptospirosis is a zoonotic feral nidal disease (synonyms: Weil-Vasilyev disease, waterborne fever) running as an acute febrile disease with evident intoxication, renal, hepatic, and central nervous system involvements, evolving hemorrhagic syndrome mainly with its severe complicated course and high mortality rates. The clinical features of leptospirosis have been little studied in patients with comorbidities. Its poor outcomes are generally due to the development of serious complications, such as infection-toxic shock, acute renal and hepatic failure, massive hemorrhagic syndrome, infectious myocarditis, etc. This communication describes a case of the disease with developed irreversible complications: involvement of the kidney and heart in 1 case and that of the kidney with a fatal outcome. Leptospirosis mortality is frequently associated with delayed diagnosis due to the misunderstanding of the clinical picture of this disease (particularly in its similarity to hemorrhagic fever with renal syndrome). The severer acute course of the infectious process in leptospirosis is burdened with the activation of the infection foci existing in the body or the exacerbation of somatic comorbidity, which substantiates the necessity of goal-oriented early individual, background pathology-depended correction of diagnostic, etiotropic, and pathogenetic therapy, rehabilitative measures. Comorbidities in patients with leptospirosis exert a significant impact on the development of its clinical form and the course of the infectious process manifesting itself as its worsening, the more frequent and more prolonged signs ofendogenous intoxication and multiple organ dysfunction, and a larger number of nonspecific complications in the structure of causes of deaths.