tailieunhanh - báo cáo khoa học: "Fulminant Leptospirosis (Weil’s disease) in an urban setting as an overlooked cause of multiorgan failure: a case report"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Fulminant Leptospirosis (Weil’s disease) in an urban setting as an overlooked cause of multiorgan failure: a case report | Maroun et al. Journal of Medical Case Reports 2011 5 7 http content 5 1 7 JOURNALOF medical Ur Case REPORTS CASE REPORT Open Access Fulminant Leptospirosis Weil s disease in an urban setting as an overlooked cause of multiorgan failure a case report Elias Maroun Anurag Kushawaha Elie El-Charabaty Neville Mobarakai Suzanne El-Sayegh Abstract Introduction Leptospirosis has recently come to international attention as a globally important re-emerging infectious disease. Our case is unusual given the season location and setting in which leptospirosis occurred. According to the New York City Board of Health there were only two other cases of leptospirosis in New York City in the year that our patient was diagnosed. Case presentation A 49-year-old healthy Chinese man presented to our hospital with sepsis and multiorgan failure. The patient did not respond to antibiotics and his multiorgan failure worsened. His workup did not show any significant findings except for a positive nasopharyngeal swab result for influenza A. Later the patient developed hemoptysis with evidence of bilateral infiltrates on radiography. His status mildly improved after he was started on steroids. Eventually a microagglutination test confirmed the presence of antibodies against Leptospira icterohaemorrhagiae. The patient subsequently recovered after a course of intravenous antibiotics. Conclusion The case of fulminant leptospirosis presented here should serve to alert health care providers and the general public to the clinical importance of this severe sometimes fatal disease. Leptospirosis should be considered early in the diagnosis of any patient with acute non-specific febrile illness with multiorgan system involvement or high fever in a returning traveler. In addition not only should it be considered in tropical and rural areas between late summer to early fall but also in any location or time if the risk factors are present. Introduction Leptospirosis is a zoonosis