Liao Chen-Yi, Ben Ren-Jy, Wu Hau-Ming, Chang Shih-Kun, Liu Mei-Yu, Chin Hsien-Kuo, Yeh Yen-Cheng
Department of Medicine, Kaohsiung Armed Forces General Hospital, Taiwan.
Intern Med. 2015;54(22):2943-6. doi: 10.2169/internalmedicine.54.4528. Epub 2015 Nov 15.
Leptospirosis is recognized as a zoonotic disease that is emerging worldwide. 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 like Taiwan. The severe pulmonary form of leptospirosis is a lesser known entity and is characterized by intra-alveolar hemorrhage and can lead to acute respiratory failure with resistant hypoxemia, which leads to high mortality rates despite maximally invasive mechanical ventilation and adequate treatment. We herein present a case of severe leptospirosis complicated by massive pulmonary hemorrhage, which was successfully managed by extra corporeal membrane oxygenation.
钩端螺旋体病被认为是一种正在全球范围内出现的人畜共患病。严重表现与高发病率和死亡率相关，因此可能对公共卫生构成重大风险，特别是在某些高流行地区，如台湾。严重肺部型钩端螺旋体病是一种鲜为人知的病症，其特征为肺泡内出血，并可导致伴有顽固性低氧血症的急性呼吸衰竭，尽管采取了最大程度的有创机械通气和适当治疗，仍会导致高死亡率。我们在此报告一例严重钩端螺旋体病并发大量肺出血的病例，该病例通过体外膜肺氧合成功治愈。
