Clarissou J, le Calvez J-F, Desbouchages L, Ayoub N, Troche G, Priolet B, Bruneel F, Guézennec P, Petitpretz P, Bedos J-P
Service de Réanimation Médico-Chirurgicale, Hôpital André Mignot, CH Versailles, Le Chesnay, France.
Rev Mal Respir. 2003 Sep;20(4):609-13.
Leptospirosis is a rare cause of alveolar haemorrhage. The diagnosis is often delayed particularly when the mode of infection is atypical. These serious complications require prompt antibiotic treatment.
A 21-year-old man was involved in a road accident and found lying unconscious in a roadside ditch containing stagnant water. Ten days later he presented with bilateral interstitial pneumonia and rapidly increasing hypoxaemia associated with cholestasis and liver cell necrosis. Broncho-alveolar lavage revealed alveolar haemorrhage. There was satisfactory resolution following antibiotic therapy.
The diagnosis of leptospirosis was considered initially despite negative serology (Martin and Petit) and confirmed by sero-conversion 20 days after the onset of symptoms.
钩端螺旋体病是肺泡出血的罕见病因。诊断常常延迟，尤其是当感染方式不典型时。这些严重并发症需要及时进行抗生素治疗。
一名21岁男性遭遇道路交通事故，被发现昏迷在路边一滩积水中。十天后，他出现双侧间质性肺炎，并伴有迅速加重的低氧血症，同时伴有胆汁淤积和肝细胞坏死。支气管肺泡灌洗显示存在肺泡出血。抗生素治疗后病情得到了满意的缓解。
尽管血清学检查（马丁和珀蒂法）结果为阴性，但最初仍考虑为钩端螺旋体病，症状出现20天后血清学转换证实了诊断。
