Schenk Laura Katharina, Pavenstädt Hermann, Kümpers Philipp
Medizinische Klinik und Poliklinik D, Universitätsklinik Münster.
Dtsch Med Wochenschr. 2018 Feb;143(4):263-266. doi: 10.1055/s-0043-122705. Epub 2018 Feb 26.
In winter, a 37-year old male patient consulted our outpatient clinic complaining about fever, malaise and headache. He had returned from vacation in Thailand 14 days earlier.
Clinical findings, laboratory examinations and apparative diagnostics revealed a pulmo-renal syndrom accompagnied by multi-organ failure.
Finally, we could confirm that our patient suffered from leptospirosis.
The patient received a penicillin-based antibiotic treatment.
Two days after presentation, the patient had to be transferred to the intensive care unit. Noninvasive respiratory support and hemodialysis helped to stabilize the patient. Finally, the patient could be discharged after four weeks in the hospital.
Taking into account the seasonal accumulation of flu-like symptoms in winter and the patient's stay in a tropical region, differential-diagnostics were challenging in this case. Leptospirosis often presents as pulmp-renal syndrome.
冬季，一名37岁男性患者到我们门诊就诊，主诉发热、全身不适和头痛。他14天前从泰国度假归来。
临床检查、实验室检查和器械诊断显示为肺肾综合征并伴有多器官功能衰竭。
最终，我们确诊该患者患有钩端螺旋体病。
患者接受了以青霉素为基础的抗生素治疗。
就诊两天后，患者不得不转入重症监护病房。无创呼吸支持和血液透析有助于稳定患者病情。最终，患者住院四周后出院。
考虑到冬季流感样症状的季节性积聚以及患者曾身处热带地区，该病例的鉴别诊断具有挑战性。钩端螺旋体病常表现为肺肾综合征。
