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Severe leptospirosis complicated with multiorgan dysfunction successfully managed with plasma exchange: a case report

Manana Dewage Sankani Vishvara Kularathna1, Senanayake Abeysinghe Mudiyanselage Kularatne2, Manoji Pathirage2

  • 1Teaching Hospital Peradeniya, Peradeniya, Sri Lanka. vishvarakularathna@gmail.com.

Journal of Medical Case Reports
|December 14, 2021
PubMed
Abstract

Insights

Severe leptospirosis can cause multiorgan failure. Therapeutic plasma exchange (TPE) offers a life-saving treatment option for patients with severe leptospirosis and organ damage.

Area of Science:

  • Infectious Diseases
  • Nephrology
  • Critical Care Medicine

Background:

  • Leptospirosis is a zoonotic disease caused by Leptospira spirochetes, prevalent in tropical regions.
  • It can range from subclinical infections to severe illness with high morbidity and mortality.
  • Prompt diagnosis and management are crucial for patient outcomes.

Observation:

  • A case of a 77-year-old Sri Lankan man with severe leptospirosis is presented.
  • The patient developed acute kidney injury, pulmonary hemorrhages, myocarditis, and severe thrombocytopenia.
  • Initial treatment with antibiotics and steroids was insufficient.

Findings:

  • The patient showed a dramatic improvement after undergoing two cycles of therapeutic plasma exchange (TPE).
  • TPE effectively managed the severe complications of leptospirosis.
  • This highlights the potential efficacy of TPE in critical cases.

Implications:

  • Therapeutic plasma exchange (TPE) is a potentially life-saving intervention for severe leptospirosis.
  • TPE may be a critical treatment modality for patients with multiorgan failure due to leptospirosis.
  • This case underscores the importance of considering advanced therapies in refractory severe infections.
Keywords:
LeptospirosisMultiple organ failureMyocarditisPlasma exchangePulmonary hemorrhagesZoonotic infection

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