Use of Aminocaproic Acid in Combination With Extracorporeal Membrane Oxygenation in a Case of Leptospirosis Pulmonary Hemorrhage Syndrome

Clinical Medicine Insights: Circulatory, Respiratory and Pulmonary Medicine

Case Report

Gaurav Budhrani¹  Rodrigo Mendirichaga²  Miguel Pardinas²  Rajan Garg³  Rene Rico³  Luis Rosario³  Horst Baier³  Stefanie Krick³  Anthony Panos⁴ 

[1] Division of Anesthesiology, Emory University, Atlanta, GA, USA;Division of Internal Medicine, Jackson Memorial Hospital and University of Miami Miller School of Medicine, Miami, FL, USA;Division of Pulmonary, Critical Care and Sleep Medicine, Jackson Memorial Hospital and University of Miami Miller School of Medicine, Miami, FL, USA;Division of Thoracic Transplantation and Cardiothoracic Surgery, Jackson Memorial Hospital and University of Miami Miller School of Medicine, Miami, FL, USA;

关键词: Leptospirosis;    pulmonary hemorrhage;    ECMO;    aminocaproic acid;   

DOI  :  10.1177/1179548416686068

 received in 2016-06-14, accepted in 2016-09-27,  发布年份 2017

来源: Sage Journals

【 摘 要 】

A 32-year-old man presented with a 10-day history of fever, chills, nausea, vomiting, myalgia, nonproductive cough, and worsening dyspnea after freshwater swimming in the Caribbean 1 week prior to presentation. Shortly after arrival at the hospital, the patient developed severe respiratory distress with massive hemoptysis. Based on serologic workup, he was diagnosed with leptospirosis pulmonary hemorrhage syndrome leading to diffuse alveolar hemorrhage, severe hypoxemic respiratory failure, and multiorgan failure. He received appropriate antibiotic coverage along with hemodynamic support with norepinephrine and vasopressin, mechanical ventilation, and renal replacement therapy in an intensive care unit. Introduction of extracorporeal membrane oxygenation was initiated to provide lung-protective ventilation supporting the recovery of his pulmonary function. Aminocaproic acid was used to stop and prevent further alveolar hemorrhage. He fully recovered thereafter; however, it is uncertain whether it was the use of aminocaproic acid that led to the resolution of his disease.

【 授权许可】

CC BY-NC   
© The Author(s) 2017