Vivero-Tellez David, Contreras-Ortíz Joshua Antonio, Flores-Martínez Emmanuel, Gracia-Ramos Abraham Edgar
Department of Internal Medicine, Hospital Regional de Alta Especialidad de Zumpango, Estado de México, Mexico.
Department of Rheumatology, Hospital Regional de Alta Especialidad de Zumpango, Estado de México, Mexico.
Clin Med Res. 2025 Mar;23(1):26-31. doi: 10.3121/cmr.2025.1963.
Leptospirosis is a zoonotic disease caused by spirochetes from the species Weil's disease, the more severe manifestation of leptospirosis, is characterized by a combination of jaundice, renal injury, and hemorrhages. Diagnosing severe leptospirosis in patients with acute life-threatening multi-organ dysfunction at presentation can be challenging because of the non-specific clinical manifestations. This report describes a case of severe leptospirosis with jaundice, acute renal dysfunction, severe thrombocytopenia, pulmonary hemorrhage, and unusual manifestations, including rhabdomyolysis, acalculous cholecystitis, and pancreatitis, which required a comprehensive diagnostic evaluation of possible causes to confirm the diagnosis. The case highlights the importance of clinicians considering leptospirosis in the differential diagnosis of a patient with cryptogenic sepsis who develops multiple organ dysfunction.
钩端螺旋体病是一种由钩端螺旋体属螺旋体引起的人畜共患病。韦尔氏病是钩端螺旋体病更严重的表现形式，其特征为黄疸、肾损伤和出血同时出现。由于临床表现不具特异性，对于就诊时出现危及生命的急性多器官功能障碍的患者，诊断严重钩端螺旋体病可能具有挑战性。本报告描述了一例严重钩端螺旋体病病例，该病例伴有黄疸、急性肾功能不全、严重血小板减少、肺出血以及包括横纹肌溶解、无结石性胆囊炎和胰腺炎在内的异常表现，需要对可能病因进行全面的诊断评估以确诊。该病例凸显了临床医生在对出现多器官功能障碍的不明原因脓毒症患者进行鉴别诊断时考虑钩端螺旋体病的重要性。
