de Carvalho J E, Marchiori E dos S, Guedes e Silva J B, Netto B A, Tavares W, de Paula A V
Hospital Universitário Antônio Pedro, Niterói, RJ.
Rev Soc Bras Med Trop. 1992 Jan-Mar;25(1):21-30. doi: 10.1590/s0037-86821992000100004.
To study the pulmonary complications in leptospirosis case records of 23 such patients admitted at the Hospital Universitário Antônio Pedro, Universidade Federal Fluminense, Niterói, Brasil, were reviewed. Hemoptysis were seen in 21.7% and sputal blood in 30.4% of patients. Arterial gasometry detected hypoxemia and hypocapnia in most cases. Thoracic radiology showed an alveolar pattern in 60% of the patients, alveolo-interstitial in 20%, interstitial in 6%, and in 14% the lungs were considered to be normal. Necropsy of 13 cases showed edema, congestion and hemorrhage in the lungs in all cases. Hyaline membrane was found in 30% and fibrin thrombi in 46% of these cases, resulting in a diagnosis of adult respiratory distress syndrome and acute disseminated intravascular coagulation (consumption coagulopathy) in leptospirosis.
为研究钩端螺旋体病的肺部并发症，我们回顾了巴西尼泰罗伊市弗卢米嫩塞联邦大学安东尼奥·佩德罗大学医院收治的23例此类患者的病历。咯血在21.7%的患者中出现，痰中带血在30.4%的患者中出现。大多数病例的动脉血气分析检测到低氧血症和低碳酸血症。胸部放射学检查显示，60%的患者为肺泡型，20%为肺泡间质型，6%为间质型，14%的患者肺部被认为正常。13例尸检病例均显示肺部有水肿、充血和出血。在这些病例中，30%发现透明膜，46%发现纤维蛋白血栓，导致钩端螺旋体病诊断为成人呼吸窘迫综合征和急性弥散性血管内凝血（消耗性凝血病）。
