A catastrophic leptospirosis case with multisystemic involvement

Abstract

Leptospirosis is a systemic infection with varying degree of clinical manifestations from mild to fatal disease. Clinical suspicion is very important to identify leptospirosis. A field worker patient was admitted to our clinic with emerging acute hepatitis and renal failure accompanying conjunctivitis, autoimmune hemolytic anemia, thrombocytopenia, pneumonia and epididymorchitis. During the follow-up the patient was transmitted to intensive care unit, and hemodialysis with plasma exchange was performed. Usually mild disease is treated in outpatient clinics because severe organ failure is experienced rarely. Alternative treatments such as plasma exchange and corticosteroids may also provide benefits especially in patients who were unresponsive to classical therapies.

Keywords

• Leptospirosis,Acute Hepatitis,Plasmapheresis,Hemodialysis

Multisistemik tutulumlu katastrofik leptospirozis vakası

Öz

Leptospirozis, hafif ile ölümcül hastalığa kadar değişen derecede klinik bulgulara sahip sistemik bir enfeksiyondur. Teşhis konusundaki en önemli vizyonun klinik şüpheniz olduğu düşünülmektedir. Kliniğimize, konjontivit, otoimmün hemolitik anemi, trombositopeni, pnömoni ve epididimo-orşitin eşlik ettiği akut hepatit ve böbrek yetmezliği tablosuyla başvuran ; takibinde yoğun bakım ünitesine alınıp plazma değişimi ve hemodiyaliz ile takip edilen tarlada çalışan bir işçiyi sunduk. Leptospiroziste genellikle hafif hastalık ayaktan tedavi edilirken, ciddi organ yetmezliği nadiren görülür. Plazma değişimi ve kortikosteroidler gibi alternatif tedaviler, özellikle klasik tedavilere yanıtsız kabul edilen hastalarda fayda sağlayabilir.

Anahtar Kelimeler

• Leptospirozis,Akut hepatit,Plazmaferez,Hemodiyaliz

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