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A case of severe leptospirosis with Jarisch-Herxheimer reaction presenting as respiratory failure

Yunzhen Shi1, Wanru Guo2, Ming Hu2

  • 1Department of Infectious Diseases, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, Zhejiang, China.

Frontiers in Public Health
|February 27, 2023
PubMed
Abstract

Insights

Leptospirosis treatment can trigger a Jarisch-Herxheimer reaction (JHR), leading to severe complications like ARDS. This case details the evolution and imaging of JHR in leptospirosis, aiding diagnosis and management.

Area of Science:

  • Infectious Diseases
  • Zoonotic Diseases
  • Microbiology

Background:

  • Leptospirosis, a zoonotic disease caused by *Leptospira* spp., presents diagnostic challenges.
  • Treatment with penicillin or tetracycline can precipitate a Jarisch-Herxheimer reaction (JHR).
  • Severe leptospirosis with JHR can lead to acute respiratory distress syndrome (ARDS) and multi-organ failure.

Observation:

  • A case of leptospirosis complicated by pulmonary alveolar hemorrhage and JHR is presented.
  • The patient required respiratory and vasopressor support.
  • The study documents the evolutionary course and characteristic imaging features of JHR in this context.

Findings:

  • Jarisch-Herxheimer reaction (JHR) exacerbation in leptospirosis is rarely reported with detailed evolutionary and imaging data.
  • Pulmonary alveolar hemorrhage was a key complication in this case.
  • The case highlights the need for recognizing JHR in severe leptospirosis.

Implications:

  • Early diagnosis of leptospirosis and prompt recognition of JHR are crucial for effective management.
  • Understanding the imaging features of JHR can improve diagnostic accuracy.
  • Appropriate management strategies can reduce mortality in severe leptospirosis with JHR.
Keywords:
Jarisch-Herxheimer reactionimaging featuresleptospirosismetagenomic next-generation sequencingpulmonary alveolar hemorrhage

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