Clavel Marc, Lhéritier Gwenaelle, Weinbreck Nicolas, Guerlin Antoine, Dugard Anthony, Denes Eric, Vignon Philippe
Medical-Surgical Intensive Care, Dupuytren University Hospital, Limoges, France.
Crit Care Res Pract. 2010;2010:408365. doi: 10.1155/2010/408365. Epub 2010 May 26.
Severe leptospirosis usually associates shock, jaundice, renal failure, and thrombocytopenia. Massive hemoptysis due to diffuse alveolar haemorrhage may rarely occur leading to an acute respiratory failure and multiple organ failure. We present the case of an acute respiratory distress syndrome caused by a severe leptospirosis. The severity of the respiratory failure contrasted with the absence of significant liver or renal dysfunction. Bedside open lung biopsy was only consistent with a postinfectious BOOP. The diagnosis was retrospective when the niece of the patient presented with similar inaugural symptoms ten days later after being scratched by a wild rat which was considered by our patient as a pet.
严重钩端螺旋体病通常伴有休克、黄疸、肾衰竭和血小板减少。因弥漫性肺泡出血导致的大量咯血可能很少发生,进而导致急性呼吸衰竭和多器官衰竭。我们报告一例由严重钩端螺旋体病引起的急性呼吸窘迫综合征病例。呼吸衰竭的严重程度与无明显肝或肾功能障碍形成对比。床旁开放性肺活检仅符合感染后闭塞性细支气管炎伴机化性肺炎(BOOP)。当患者的侄女在被一只被患者当作宠物的野鼠抓伤十天后出现类似首发症状时,才做出回顾性诊断。