Park Y K, Park S K, Rhee Y K, Kang S K
Department of Internal Medicine, Chonbuk National University, Medical School, Chonju, Korea.
Korean J Intern Med. 1990 Jan;5(1):34-43. doi: 10.3904/kjim.1990.5.1.34.
Leptospirosis is a zoonosis with protean clinical manifestations. Its diagnosis requires a high index of suspicion and is confirmed by isolation of the organism or, more commonly, by serologic tests. In the fall of 1987, after severe flooding, we saw 93 patients with leptospirosis, confirmed by a microagglutination test. Thirteen percent of the patients had no clinical or laboratory findings except fever and headache, but the rest had mild to severe manifestations. Jaundice, renal failure, and aseptic meningitis were not common, but pulmonary symptoms, when present, were striking. The mortality rate was 5%. The main cause of death was asphyxiation due to massive hemoptysis from pulmonary hemorrhage and acute respiratory failure.
钩端螺旋体病是一种临床表现多样的人畜共患病。其诊断需要高度的怀疑指数,并通过病原体分离来确诊,更常见的是通过血清学检测来确诊。1987年秋季,在遭受严重洪水之后,我们接诊了93例经显微凝集试验确诊的钩端螺旋体病患者。13%的患者除发热和头痛外无临床或实验室检查结果,但其余患者有轻度至重度表现。黄疸、肾衰竭和无菌性脑膜炎并不常见,但肺部症状一旦出现则很明显。死亡率为5%。主要死亡原因是肺出血导致的大量咯血和急性呼吸衰竭引起的窒息。