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魏尔氏病伴多器官功能障碍、社区获得性肺炎和感染性休克:快速诊断和治疗的作用。

Weil's disease with multiple organ dysfunction, community-acquired pneumonia and septic shock: The role of rapid diagnosis and management.

机构信息

Department of Internal Medicine, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia.

Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia.

出版信息

Narra J. 2024 Apr;4(1):e587. doi: 10.52225/narra.v4i1.587. Epub 2024 Mar 2.

Abstract

Leptospirosis is an uncommon infectious illness - a spirochetal zoonosis - caused by species and the primary cause of human leptospirosis is exposure to the urine of infected rodents. Clinical manifestations of human leptospirosis are diverse, ranging from asymptomatic infection to severe life-threatening with multiorgan dysfunction. The severe condition is known as Weil's disease, which is characterized by feverish illness with jaundice, acute kidney damage, and bleeding. The aim of this case report was to present a Weil's disease which occurred simultaneously with a community-acquired pneumonia (CAP) resulting in serious complications. A 41-year-old man with Weil's disease, as well as CAP caused by , and septic shock was presented. The patient was treated accordingly after establishing the diagnosis through history taking, physical examination, and laboratory tests. In this instance, the score for diagnosing leptospirosis based on Modified Faine's Criteria was calculated resulting possible diagnoses; and therefore, therapeutic management was initiated. Despite presenting with severe symptoms, the patient recovered completely after receiving antibiotics and supportive care. This study highlights that when a patient has Weil's disease and a CAP infection, which could cause unfavorable consequence, a prompt diagnosis and proper treatment could result satisfied patient recovery.

摘要

钩端螺旋体病是一种罕见的传染病——一种螺旋体动物病,由 种引起,人类钩端螺旋体病的主要病因是接触感染啮齿动物的尿液。人类钩端螺旋体病的临床表现多种多样,从无症状感染到严重的危及生命的多器官功能障碍。严重的情况被称为韦尔病,其特征是发热伴黄疸、急性肾损伤和出血。本病例报告的目的是介绍同时发生的韦尔病和社区获得性肺炎(CAP)导致严重并发症的情况。介绍了一位 41 岁的男性,患有韦尔病、 引起的 CAP 和感染性休克。通过病史询问、体格检查和实验室检查确诊后,对患者进行了相应的治疗。在这种情况下,根据改良 Faine 标准计算出钩端螺旋体病的诊断评分,得出可能的诊断;因此,开始了治疗管理。尽管患者出现严重症状,但在接受抗生素和支持性治疗后完全康复。本研究强调,当患者同时患有韦尔病和 CAP 感染时,可能会导致不良后果,及时诊断和适当治疗可以使患者康复满意。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/89bd/11125387/d4cbc0d99fbb/NarraJ-4-e587-g001.jpg

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