Severe Leptospirosis (Weil's Disease) with Multiple Organ Failure in Urban Setting: A Case Report
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Leptospirosis is a rare disease that could cause multiple organ failures and death if left untreated. The correct treatment will determine the recovery of patients. A 28-years old male came to the Emergency Department with profuse diarrhea. No prior medical history; worked as a private employee recently assigned to collect rat traps one week before. Laboratories show severe thrombocytopenia, acute liver failure, and acute renal failure support by imaging with the conclusion of hepatomegaly with normal kidney size. During observation in the emergency room, the patient worsens into septic shock. The patient was treated in intensive care, diagnosed with Weil's disease, and treated given antibiotics with aggressive fluid therapy; dialysis was postponed, and close monitoring of the patient's symptoms and organ function. After five days of care, clinical symptoms and organ function improved, and the patient was discharged well. Diagnosis of Leptospirosis is challenging with a combination of signs and symptoms that are not commonly found. Therefore, primary treatment is antibiotic and supportive care such as renal replacement therapy is not routinely needed as long there are improvements in close monitoring. This objective is to increase awareness and treatment option for further severe leptospirosis cases
Wang S, Stobart Gallagher MA, Dunn N. Leptospirosis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 [cited 2022 Sep 7]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK441858/
Leptospirosis prevention and control in Indonesia [Internet]. [cited 2022 Sep 9]. Available from: https://www.who.int/indonesia/news/detail/24-08-2020-leptospirosis-prevention-and-control-in-indonesia
Jameson, Fauci, Kasper, Hauser, Longo, Loscalzo. Harrison's Priciples of Internal Medicine. 20th Edition. 1290–1295 p.
Timing of Initiation of Renal-Replacement Therapy in Acute Kidney Injury. New England Journal of Medicine. 2020 Jul 16;383(3):240–51.
Leptospirosis | CDC [Internet]. 2019 [cited 2022 Sep 21]. Available from: https://www.cdc.gov/leptospirosis/index.html
Gasem MH, Hadi U, Alisjahbana B, Tjitra E, Hapsari MMDEAH, Lestari ES, et al. Leptospirosis in Indonesia: diagnostic challenges associated with atypical clinical manifestations and limited laboratory capacity. BMC Infectious Diseases. 2020 Feb 27;20(1):179.
Duarte-Neto AN, Croda J, Pagliari C, Soriano FG, Nicodemo AC, Duarte MIS. Severe Leptospirosis Features in the Spleen Indicate Cellular Immunosuppression Similar to That Found in Septic Shock. Frontiers in Immunology [Internet]. 2019 [cited 2022 Sep 24];10. Available from: https://www.frontiersin.org/articles/10.3389/fimmu.2019.00920
Lippi G, Favaloro EJ, Buoro S. Platelet Transfusion Thresholds: How Low Can We Go in Respect to Platelet Counting? Semin Thromb Hemost. 2020 Apr;46(3):238–44.
Lie KC, Lau CY, Van Vinh Chau N, West TE, Limmathurotsakul D, Sudarmono P, et al. Utility of SOFA score, management and outcomes of sepsis in Southeast Asia: a multinational multicenter prospective observational study. j intensive care. 2018 Feb 14;6(1):9.
Yilmaz H, Turhan V, Yasar KK, Hatipoglu M, Sunbul M, Leblebicioglu H. Characteristics of leptospirosis with systemic inflammatory response syndrome: a multicenter study. Ann Clin Microbiol Antimicrob. 2015 Dec 21;14:54.
El Hasbani G, Farooqui SR, Kofahi A, Saeed Y, Tayeh O, Abu-Hishmeh M, et al. Unusual presentation of urban leptospirosis complicated by a septic shock. IDCases. 2019 Jun 13;17:e00574.
Hamzaoui O, Scheeren TWL, Teboul JL. Norepinephrine in septic shock: when and how much? Current Opinion in Critical Care. 2017 Aug;23(4):342–7.
Guerrier G, Lefèvre P, Chouvin C, D'Ortenzio E. Jarisch-Herxheimer Reaction Among Patients with Leptospirosis: Incidence and Risk Factors. Am J Trop Med Hyg. 2017 Apr;96(4):791–4.
Guerrier G, D'Ortenzio E. The Jarisch-Herxheimer reaction in leptospirosis: a systematic review. PLoS One. 2013;8(3):e59266.
Goarant C. Leptospirosis: risk factors and management challenges in developing countries. Research and Reports in Tropical Medicine. 2016 Dec 31;7:49–62.
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