Zhang YuChou, Yin MingJing, Wen HanChun
Department of Critical Care Medicine, The First Affiliated Hospital of Guangxi Medical University, Guangxi Clinical Research Center for Critical Care Medicine, Guangxi, China.
Front Med (Lausanne). 2025 Jan 13;11:1495324. doi: 10.3389/fmed.2024.1495324. eCollection 2024.
Leptospirosis is an acute infectious disease that occurs by infection, progresses rapidly, and has a high mortality rate, with an estimated 1.2 million new cases and nearly 59,000 deaths each year. Due to its diverse clinical manifestations, diagnosis is often delayed. Therefore, it is necessary to pay attention to its clinical manifestations, diagnostic techniques, and treatment methods.
A 51-year-old male patient from the Han ethnic group experienced fever, chills, headache, and overall fatigue after being exposed to rain, followed by yellowing of the skin and worsening of breathing difficulties. Metagenomic next-generation sequencing (mNGS) indicates infection with leptospirosis and influenza A. After 5 days of treatment with venovenous extracorporeal membrane oxygenation (VV-ECMO), Penicillium, and Oseltamivir, the condition improved.
Leptospirosis improves with VV-ECMO support and anti-infective treatment with penicillin and oseltamivir. VV-ECMO provides a therapeutic time window for rescue, and mNGS lays a foundation for early detection of etiology of leptospirosis.
钩端螺旋体病是一种通过感染发生的急性传染病，进展迅速，死亡率高，估计每年有120万新发病例和近59000人死亡。由于其临床表现多样，诊断往往延迟。因此，有必要关注其临床表现、诊断技术和治疗方法。
一名51岁汉族男性患者淋雨后感发热、寒战、头痛及全身乏力，随后出现皮肤黄染及呼吸困难加重。宏基因组下一代测序（mNGS）显示感染钩端螺旋体病和甲型流感。经静脉-静脉体外膜肺氧合（VV-ECMO）、青霉素和奥司他韦治疗5天后，病情好转。
钩端螺旋体病经VV-ECMO支持及青霉素和奥司他韦抗感染治疗后病情改善。VV-ECMO为抢救提供了治疗时间窗，mNGS为早期发现钩端螺旋体病病因奠定了基础。
