Binder W D, Mermel L A
Department of Emergency Medicine, Rhode Island Hospital and Brown University School of Medicine, Providence 02903, USA.
J Emerg Med. 1998 Nov-Dec;16(6):851-6. doi: 10.1016/s0736-4679(98)00097-3.
Leptospiosis is a common zoonosis affecting most mammals. Leptospirosis has protean manifestations ranging from a flu-like illness to fulminant hepatic and renal failure culminating in death. Although the diagnosis is often not considered upon presentation, the literature suggests that leptospirosis is a reemerging infectious disease in urban centers throughout the industrialized world. It will be incumbent upon Emergency Physicians to include this spirochetal disease in the differential diagnosis of febrile patients with appropriate risk factors and symptomatology. We present the case of a 36 year-old woman who presented to the Emergency Department with fever and hypotension. We review the literature on leptospirosis with specific focus on risk factors and pathogenesis, clinical manifestations, diagnosis, treatment, and outcome.
钩端螺旋体病是一种常见的人畜共患病，可影响大多数哺乳动物。钩端螺旋体病有多种表现形式，从类似流感的疾病到暴发性肝肾功能衰竭，最终导致死亡。尽管患者就诊时往往不会考虑到该病的诊断，但文献表明，在整个工业化世界的城市中心，钩端螺旋体病是一种再度出现的传染病。对于有适当风险因素和症状的发热患者，急诊医生有责任将这种螺旋体病纳入鉴别诊断。我们报告一例36岁女性患者，她因发热和低血压就诊于急诊科。我们回顾了关于钩端螺旋体病的文献，特别关注风险因素和发病机制、临床表现、诊断、治疗及预后。
