MANAGEMENT OF WEIL'S DISEASE WITH SEPSIS AND MULTIPLE ORGAN DYSFUNCTION SYNDROME
DOI:
https://doi.org/10.61841/wng9f376Abstract
Leptospirosis is a common zoonotic disease with a wide range of clinical manifestations, specifically in tropical regions. Weil's disease is considered a severe form of leptospirosis seen in a minority of leptospirosis cases with considerable mortality. These patients typically developed multiple organ dysfunction (MOD) of acute kidney injury, jaundice, and ARDS. We reported a case of a 62-year-old male transferred to our intensive care unit due to sepsis, severe leptospirosis jaundice, acute respiratory distress, thrombocytopenia, and renal injury. The patient was successfully managed with appropriate antimicrobial treatment and other supportive management, including mechanical ventilation and renal replacement therapy. Moreover, leptospirosis should be considered in any location wherever risk factors are present, not just in epidemic and tropical areas. In this case, we pointed out that serious complications of leptospirosis, such as multiple organ dysfunction, may happen. In such cases, adopting an integrated multidisciplinary team approach is essential to prevent complications and reduce mortality. Keywords: Weil's disease,Sepsis, MOD, AKI, ARDS
References
Karnad DR, Richards GA, Silva GS, Amin P. Tropical diseases in the ICU: A syndromic approach to diagnosis and treatment. J Crit Care. 2018;46.
Karnik ND, Patankar AS. Leptospirosis in intensive care unit. Indian Journal of Critical Care Medicine. 2021;25(S2).
Chawla V, Trivedi TH, Yeolekar ME. Epidemic of leptospirosis: An ICU experience. Journal of Association of Physicians of India. 2004;52(AUG).
Sethi S, Sharma N, Kakkar N, Taneja J, Chatterjee SS, Banga SS, et al. Increasing trends of leptospirosis in Northern India: A clinico-epidemiological study. PLoS Negl Trop Dis. 2010;4(1).
Ajjimarungsi A, Bhurayanontachai R, Chusri S. Clinical characteristics, outcomes, and predictors of leptospirosis in patients admitted to the medical intensive care unit: A retrospective analysis. J Infect Public Health. 2020;13(12).
Smith S, Kennedy BJ, Dermedgoglou A, Poulgrain SS, Paavola MP, Minto TL, et al. A simple score to predict severe leptospirosis. PLoS Negl Trop Dis. 2019;13(2).
Deodhar D, John M. Leptospirosis: Experience at a tertiary care hospital in northern India. National Medical Journal of India. 2011;24(2).
Mathew T, Satishchandra P, Mahadevan A, Nagarathna S, Yasha TC, Chandramukhi A, et al.
Neuroleptospirosis - Revisited: Experience from a tertiary care neurological centre from south India. Indian Journal of Medical Research. 2006;124(2).
Shastri M, Diwanji N, Desai E, Chitara M, Bhatt A. Spectrum of Radiological Findings in Leptospirosis on Chest Radiograph and Ultrasonography-Study during Epidemics in South Gujarat Region of India. International Journal of Anatomy, Radiology and Surgery [Internet]. 2017 Oct [cited 2023 Nov 16];6(4). Available from:
https://www.ijars.net/articles/PDF/2306/26056_CE[VSU]_F(GH)_PF1(VSUAK)_PFA(GG)_PF2(VSU _GG).pdf
Ittyachen AM, Krishnapillai T V., Nair MC, Rajan AR. Retrospective study of severe cases of leptospirosis admitted in the intensive care unit. J Postgrad Med. 2007;53(4).
Brito de T, Penna DO, Hoshino S, Pereira VG, Caldas AC, Rothstein W. Cholestasis in human leptospirosis: a clinical, histochemical, biochemical and electron microscopy study based on liver biopsies. Beitr Pathol Anat. 1970;140(3).
de Brito T, Machado MM, Montans SD, Hoshino S, Freymüller E. Liver biopsy in human leptospirosis:
A light and electron microscopy study. Virchows Arch Pathol Anat Physiol Klin Med. 1967;342(1).
De Brito T, Freymüller E, Hoshino S, Penna DO. Pathology of the kidney and liver in the experimental leptospirosis of the guinea-pig - A light and electron microscopy study. Virchows Arch Pathol Anat Physiol Klin Med. 1966;341(1).
Miller NG, Wilson RB. Electron microscopy of the liver of the hamster during acute and chronic leptospirosis. Am J Vet Res. 1966;27(119).
Wiwanitkit V. Peritoneal dialysis in leptospirosis-induced acute renal failure: An appraisal on Thai patients. Vol. 28, Renal Failure. 2006.
Wilkins TR, Wilkins RL. Clinical and radiographic evidence of pneumonia. Vol. 77, Radiologic technology. 2005.
Smith S, Liu YH, Carter A, Kennedy BJ, Dermedgoglou A, Poulgrain SS, et al. Severe leptospirosis in tropical Australia: Optimising intensive care unit management to reduce mortality. PLoS Negl Trop Dis. 2019;13(12).
Bao QH, Yu L, Ding JJ, Chen YJ, Wang JW, Pang JM, et al. Severe community-acquired pneumonia caused by Leptospira interrogans: A case report and review of literature. World J Clin Cases. 2021;9(8).
Lippi G, Favaloro EJ, Buoro S. Platelet Transfusion Thresholds: How Low Can We Go in Respect to Platelet Counting? Semin Thromb Hemost. 2020;46(3).
Higgins R. A minireview of the pathogenesis of acute leptospirosis. Vol. 22, Canadian Veterinary Journal. 1981.
Coursin DB, Updike SJ, Maki DG. Massive rhabdomyolysis and multiple organ dysfunction syndrome caused by leptospirosis. Intensive Care Med. 2000;26(6).
Kirchner GI, Krug N, Bleck JS, Fliser D, Manns MP, Wagner S. Fulminant Course of Leptospirosis Complicated by Multiple Organ Failure. Z Gastroenterol. 2001;39(8).
Davenport A, Rugman FP, Desmond MJ, Ganta R. Is thrombocytopenia seen in patients with leptospirosis immunologically mediated? J Clin Pathol. 1989;42(4).
Nicodemo AC, Del Negro G, Amato Neto V. Thrombocytopenia and leptospirosis. Rev Inst Med Trop Sao Paulo. 1990;32(4).
De Francesco Daher E, Soares DS, de Menezes Fernandes ATB, Girão MMV, Sidrim PR, Pereira EDB, et al. Risk factors for intensive care unit admission in patients with severe leptospirosis: A comparative study according to patients’ severity. BMC Infect Dis. 2016;16(1).
Alian S, Asghari H, Najafi N, Davoudi A, Yazdani J. Corticosteroid in the Treatment of Moderate to Severe Thrombocytopenia Due to Leptospirosis. Iran Red Crescent Med J. 2014;16(10).
Trivedi S V., Chavda RK, Wadia PZ, Sheth V, Bhagade PN, Trivedi SP, et al. The role of glucocorticoid pulse therapy in pulmonary involvement in leptospirosis. J Assoc Physicians India. 2001;49.
Shenoy V V., Nagar VS, Chowdhury AA, Bhalgat PS, Juvale NI. Pulmonary leptospirosis: An excellent response to bolus methylprednisolone. Postgrad Med J. 2006;82(971).
Costa F, Hagan JE, Calcagno J, Kane M, Torgerson P, Martinez-Silveira MS, et al. Global Morbidity and Mortality of Leptospirosis: A Systematic Review. PLoS Negl Trop Dis. 2015;9(9).
Miailhe AF, Mercier E, Maamar A, Lacherade JC, Le Thuaut A, Gaultier A, et al. Severe leptospirosis in non-tropical areas: a nationwide, multicentre, retrospective study in French ICUs. Intensive Care Med. 2019;45(12).
Weeratunga PN, Fernando S, Sriharan S, Gunawardena M, Wijenayake S. Determinants of mortality and impact of therapy in patients with leptospirosis admitted for intensive care in a Sri Lankan hospital - A three year retrospective study. Pathog Glob Health. 2015;109(8).
Downloads
Published
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Licensing
Ninety Nine Publication publishes articles under the Creative Commons Attribution 4.0 International License (CC BY 4.0). This licensing allows for any use of the work, provided the original author(s) and source are credited, thereby facilitating the free exchange and use of research for the advancement of knowledge.
Detailed Licensing Terms
Attribution (BY): Users must give appropriate credit, provide a link to the license, and indicate if changes were made. Users may do so in any reasonable manner, but not in any way that suggests the licensor endorses them or their use.
No Additional Restrictions: Users may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.