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Case Reports
. 2014 Oct;2(5):191-6.
doi: 10.1002/ccr3.91. Epub 2014 Sep 15.

Severe Leptospira interrogans serovar Icterohaemorrhagiae infection with hepato-renal-pulmonary involvement treated with corticosteroids

Marco H Schulze  1 , Heribert Raschel  2 , Heinz-Jakob Langen  3 , August Stich  4 , Dennis Tappe  5
Affiliations
Case Reports

Severe Leptospira interrogans serovar Icterohaemorrhagiae infection with hepato-renal-pulmonary involvement treated with corticosteroids

Marco H Schulze et al. Clin Case Rep. 2014 Oct.

Abstract

The traditional concept of immediate antibiotic treatment in suspected leptospirosis seems to be especially important for patients up to day 4 of clinical illness. As immune mechanisms probably play a crucial role in advanced leptospirosis with presumed pulmonary hemorrhages, patients might benefit from corticosteroids or other immunosuppressive agents beside antibiotics.

Keywords: Canoeing; Leptospira interrogans; corticosteroids; hepato-pulmonary syndrome; hepato-renal syndrome; leptospirosis.

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Figures

Figure 1
Figure 1
Course of selected laboratory parameters. Maximum values for biliT, biliD, AST, and ALT are shown. Prednisolone was given over a period of 19 days, initially high doses and then gradually reduced. Penicillin was administered for 10 days from day 7 after admission (start ↑) to day 17 (end ↓). ADM, admission; DIS, discharge; OPD, visit at outpatient department; biliT, total bilirubin; biliD, direct bilirubin; AST, aspartate aminotransferase; ALT, alanine aminotransferase.
Figure 2
Figure 2
Chest X-ray on admission. Bilateral diffuse heterogeneous airspace opacities are visible which may be indicative of hemorrhages.
See this image and copyright information in PMC

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