Severe pulmonary haemorrhage syndrome in leptospirosis in a returning traveller
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Clinical presentation of leptospirosis ranges from asymptomatic infection to fulminant, life-threatening disease. Pulmonary involvement in terms of severe pulmonary haemorrhage syndrome (SPHS) has recently become a more frequently reported facet of leptospirosis and correlates with high mortality rates. It has not yet been described in returning German travellers. We present a case of a healthy young man developing massive pulmonary haemorrhage and severe ARDS requiring mechanical ventilation and high-dose catecholamines after travelling to Indonesia. Leptospirosis was verified by blood PCR as well as serology and treated with high-dose, intravenous penicillin. Outcome was favourable, the patient recovered completely. Leptospirosis and SPHS should be taken into account as an emerging infectious disease in patients with fever and lung involvement.
KeywordsLeptospirosis Severe pulmonary haemorrhage syndrome Travel medicine Emerging infectious disease
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Conflict of interest
The authors declare that they have no conflict of interest.
- 1.Sehgal S, Murhekar M, Sugunan A. Outbreak of leptospirosis with pulmonary involvement in north Andaman. Indian J Med Res. 1995;102:9–12.Google Scholar
- 5.Weil A. Peculiar acute infection with splenic enlargement, jaundice and nephritis. Dtsch Arch Klin Med. 1886;39:209.Google Scholar
- 9.Moeschlin S. Lungeninfiltrate beim Ikterus infectiosus Weil. Schwabe, Basel 1943.Google Scholar
- 14.Budiono E, Sumardi B, Hisyam B, Hartopo AB. Pulmonary involvement predicts mortality in severe leptospirosis patients. Acta Med Indones. 2009;41:11–4.Google Scholar
- 19.Wani H. Ueber die prophylaxe der Spirochaetosis icterohaemorrhagica Inada (Weilschen Krankheit) durch schutzimpfung. Z Immun Exp Ther. 1933;79:1–26.Google Scholar
- 20.Benbrik E, Pouliquen P, Dômont A. Evaluation de la tolérance de la vaccination contre Leptospira icterohaemorrhagiae chez 50 employés de canaux. Arch Mal Prof Méd Travail. 2001;62:35–40.Google Scholar
- 21.Grassmann AA, Souza JD, McBride AJA. A universal vaccine against leptospirosis: are we going in the right direction? Front Immunol. 2017;8:256.Google Scholar