Department of Intensive Care Unit, the Affiliated People's Hospital of Ningbo University, 251 East Baizhang Road, Ningbo City, 315010, Zhejiang Province, P.R. China.
BMC Infect Dis. 2020 Oct 27;20(1):794. doi: 10.1186/s12879-020-05518-1.
Pulmonary hemorrhage is an important complication of leptospirosis. Once acute respiratory distress syndrome (ARDS) occurs as a secondary condition, treatment is extremely difficult and the mortality rate is very high.
The patient was a 49-year-old. He was admitted to the hospital because he had experienced a fever and cough for 4 days. Hemorrhage, respiratory failure, ARDS and other symptoms appeared soon after admission. Due to severe pulmonary hemorrhage secondary to ARDS, mechanical ventilation was performed through tracheal intubation. During intubation, the patient suffered cardiac arrest, and the patient's condition worsened. He was confirmed to have leptospirosis through second-generation sequencing of the alveolar lavage fluid. Finally, we successfully treated the patient with penicillin as an anti-infective medication and venous-venous extracorporeal membrane oxygenation (v-vECMO). To the best of our knowledge, this report is the first to describe the successful application of ECMO in mainland China.
Leptospirosis can induce serious but transient ARDS with a better prognosis than other causes of ARDS. Our patient was successfully treated with V-vECMO.
肺出血是钩端螺旋体病的重要并发症。一旦继发急性呼吸窘迫综合征（ARDS），治疗极为困难，死亡率极高。
患者为 49 岁男性，因发热、咳嗽 4 天入院。入院后很快出现出血、呼吸衰竭、ARDS 等症状。由于 ARDS 继发严重肺出血，给予气管插管机械通气。在插管过程中，患者发生心跳骤停，病情恶化。通过肺泡灌洗液二代测序，确诊为钩端螺旋体病。最终，我们成功地使用青霉素进行抗感染治疗和静脉-静脉体外膜肺氧合（v-v ECMO）治疗。据我们所知，这是首例在中国大陆成功应用 ECMO 的报告。
钩端螺旋体病可引起严重但短暂的 ARDS，其预后优于其他 ARDS 病因。我们的患者成功地接受了 v-v ECMO 治疗。
Zotero 插件