[Predominant pulmonary manifestations in leptospirosis icterohemorrhagica]

14 cases of leptospirosis ictero-haemorrhagica observed on Reunion island with predominant or isolated pulmonary symptoms are described. Hospitalisation was motivated in every case by haemoptysis, at times profuse, which occurred in patients with fever and myalgia. The chest radiographs revealed an alveolar and/or a bilateral alveolar pattern of variable severity. In spite of the importance of chest radiography port raying an extensive and serious pneumonia in one case out of every two, the outcome was favourable with a mean time lag of one week. In three cases, an adult respiratory distress syndrome (ARDS) was seen requiring assisted ventilation and one death occurred. The diagnosis of leptospirosis may be considered, even in countries of low endemicity, in a case pneumonia with extensive haemoptysis or an adult respiratory distress syndrome whose cause is not established by the usual tests.