Helmerhorst H J F, van Tol E N, Tuinman P R, de Vries P J, Hartskeerl R A, Grobusch M P, Hovius J W
Department of Internal Medicine, Academic Medical Center, University of Amsterdam, the Netherlands.
Neth J Med. 2012 Jun;70(5):215-21.
Based on increasing incidence and the occurrence of worldwide outbreaks, leptospirosis is recognised as an emerging zoonosis. Severe manifestations are associated with high morbidity and mortality rates and may therefore pose an important risk to public health, especially in certain high prevalence areas. A considerable number of infections progress to a severe form, which can present as the well-known triad of jaundice, impaired renal function and haemorrhage, known as Weil's disease. The severe pulmonary form of leptospirosis (SPFL) is a less known entity and is characterised by intra-alveolar haemorrhage and can lead to acute respiratory failure and death when adequate treatment fails. Prognostic factors correlating with severity and survival of leptospirosis include indicators of renal failure, pulmonary involvement and electrolyte imbalances. We report an imported case of SPFL in a returning traveller, and review the literature discussing epidemiology, clinical manifestations, prognostic factors and treatment of this resurgent disease.
基于发病率的上升以及全球范围内疫情的发生，钩端螺旋体病被认为是一种新兴的人畜共患病。严重表现与高发病率和死亡率相关，因此可能对公众健康构成重大风险，尤其是在某些高流行地区。相当数量的感染会发展为严重形式，可表现为黄疸、肾功能损害和出血这一众所周知的三联征，即韦尔氏病。钩端螺旋体病的严重肺部形式（SPFL）是一个鲜为人知的实体，其特征为肺泡内出血，若治疗不当可导致急性呼吸衰竭和死亡。与钩端螺旋体病的严重程度和生存率相关的预后因素包括肾衰竭、肺部受累和电解质失衡的指标。我们报告了一例归国旅行者中输入性SPFL病例，并综述了讨论这种复发性疾病的流行病学、临床表现、预后因素和治疗的文献。
