Rock Clare, Brady Deirdre, Forde Patrick, Lucey Patricia, Horgan Mary
Department of Infectious Diseases, Cork University Hospital, Cork, Ireland.
BMJ Case Rep. 2010 Nov 5;2010:bcr0420102947. doi: 10.1136/bcr.04.2010.2947.
A 27-year-old previously healthy man was admitted to the intensive care unit with severe jaundice, dyspnoea with haemoptysis, anaemia, thrombocytopenia and acute renal injury. He had no recent history of foreign travel but had been building a shed in his back garden in Cork, Ireland, for the preceding week. The patient's history, clinical observations, haematological and radiological results were all consistent with icteric leptospirosis or Weil's disease. This was confirmed on serological testing. He completed 7 days intravenous ceftriaxone and made a complete recovery. While endemic in tropical climates, leptospirosis incidence is increasing in temperate climates. Recent cases seen in temperate climates can be severe, particularly with pulmonary manifestations. The report of this case serves to increase awareness of this re-emerging potentially fatal infectious disease.
一名27岁既往健康的男性因严重黄疸、咯血伴呼吸困难、贫血、血小板减少和急性肾损伤入住重症监护病房。他近期没有国外旅行史,但在之前的一周一直在爱尔兰科克的后花园建造一个棚屋。患者的病史、临床检查、血液学和放射学检查结果均符合黄疸型钩端螺旋体病或韦尔氏病。血清学检测证实了这一诊断。他接受了7天的静脉注射头孢曲松治疗,并完全康复。虽然钩端螺旋体病在热带气候地区为地方病,但在温带气候地区的发病率正在上升。近期在温带气候地区出现的病例可能较为严重,尤其是伴有肺部表现的病例。本病例报告旨在提高对这种再次出现的潜在致命传染病的认识。