Clinicopathological and immunohistochemical featuresof the severe pulmonary form of leptospirosis

Revista da Sociedade Brasileira de Medicina Tropical

João José Pereira Da Silva²  Marcos Olivier Dalston²  Jorge Eduardo Manhães De Carvalho²  Sérgio Setúbal²  Janice Mery Chiarino De Oliveira¹  Martha Maria Pereira¹ 

[1] ,Universidade Federal Fluminense Faculdade de Medicina Departamento de Medicina Clínica

关键词: Leptospirosis;    Weil's disease;    Pulmonary hemorrhage;    Leptospirose;    Doença de Weil;    Hemorragia pulmonar;   

DOI  :  10.1590/S0037-86822002000400017

来源: SciELO

【 摘 要 】

Four cases of severe pulmonary form of leptospirosis (SPFL) are described. In all four of these blood culture proven cases, there was severe pulmonary injury characterized by alveolar hemorrhage and acute respiratory failure. Three patients died in less than 48 hours after onset of the first respiratory signs. Leptospiral antigen detection in lung tissues was positive by immunoperoxidase in all three of these cases, suggesting that the microorganism exerts a local direct destructive action. Patients with SPFL should be carefully monitored, as the abrupt onset of severe alveolar hemorrhage can lead to respiratory insufficiency and death. The authors emphasize the importance of radiological findings and blood gas analysis for prompt clinical diagnosis, and suggest that corticosteroids, associated with antibiotics, early respiratory support, and platelet transfusions are useful as an attempt to prevent further development of SPFL.

【 授权许可】

CC BY   
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