Rajapakse Senaka, Rodrigo Chaturaka, Balaji Krishan, Fernando Sumadhya Deepika
Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Sri Lanka
Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Sri Lanka.
Trans R Soc Trop Med Hyg. 2015 May;109(5):294-302. doi: 10.1093/trstmh/trv026. Epub 2015 Mar 25.
Leptospirosis is an illness with a wide spectrum of clinical manifestations and severe illness affects nearly all organ systems. Serious and potentially life-threatening clinical manifestations of acute leptospirosis are caused by both direct tissue invasion by spirochaetes and by the host immune responses. In its severe form, leptospirosis can cause multi-organ dysfunction and death in a matter of days. Therefore it is critical to suspect and recognize the disease early, in order to initiate timely treatment. While the classical presentation of the disease is easily recognized by experienced clinicians practising in endemic regions, rarer manifestations can be easily missed. In this systematic review, we summarize the atypical manifestations reported in literature in patients with confirmed leptospirosis. Awareness of these unusual manifestations would hopefully guide clinicians towards early diagnosis.
钩端螺旋体病是一种临床表现多样的疾病，严重病例几乎会累及所有器官系统。急性钩端螺旋体病严重且可能危及生命的临床表现是由螺旋体直接侵袭组织以及宿主免疫反应共同引起的。严重的钩端螺旋体病可在数天内导致多器官功能障碍甚至死亡。因此，早期怀疑并识别该病至关重要，以便及时开展治疗。虽然在流行地区经验丰富的临床医生很容易识别该病的典型表现，但罕见表现却很容易被漏诊。在本系统评价中，我们总结了文献中报道的确诊钩端螺旋体病患者的非典型表现。了解这些不寻常的表现有望指导临床医生进行早期诊断。
