Yalcin Yusuf, Kamel Ibrahim, Singh Harinder
Internal Medicine, Carney Hospital, Tufts University School of Medicine, Boston, USA.
Internal Medicine, Carney Hospital, Tufts Medical Center, Boston, USA.
Cureus. 2024 Feb 28;16(2):e55124. doi: 10.7759/cureus.55124. eCollection 2024 Feb.
We present the case of a 37-year-old male with Weil's disease, a severe form of leptospirosis, who presented without typical ecological risk factors. Initially manifesting as weakness, muscle aches, and fever, the patient rapidly deteriorated, necessitating ICU admission due to septic shock and respiratory failure. Despite initial diagnostic challenges, including normal initial imaging and inconclusive laboratory findings, a presumptive diagnosis of leptospirosis was made using Modified Faine's criteria. Empirical antibiotic treatment with doxycycline led to significant clinical improvement, highlighting the importance of early recognition and treatment in severe cases of leptospirosis. This case underscores the need for heightened clinical suspicion and the use of diagnostic scoring systems, even in atypical presentations, to facilitate timely intervention and improve patient outcomes.
我们报告了一例37岁男性患韦尔氏病(一种严重型钩端螺旋体病)的病例,该患者并无典型的感染风险因素。患者最初表现为虚弱、肌肉酸痛和发热,随后病情迅速恶化,因感染性休克和呼吸衰竭而需要入住重症监护病房。尽管最初存在诊断挑战,包括初始影像学检查正常和实验室检查结果不明确,但根据改良的费恩标准作出了钩端螺旋体病的推定诊断。使用强力霉素进行经验性抗生素治疗使患者临床症状显著改善,这凸显了在严重钩端螺旋体病病例中早期识别和治疗的重要性。该病例强调,即使在非典型表现的情况下,也需要提高临床怀疑度并使用诊断评分系统,以便及时进行干预并改善患者预后。