Clinicopathological and immunohistochemical featuresof the severe pulmonary form of leptospirosis
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.
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Sociedade Brasileira de Medicina Tropical - SBMT
2002
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oai:scielo:S0037-868220020004000172002-08-08Clinicopathological and immunohistochemical featuresof the severe pulmonary form of leptospirosisSilva,João José Pereira daDalston,Marcos OlivierCarvalho,Jorge Eduardo Manhães deSetúbal,SérgioOliveira,Janice Mery Chiarino dePereira,Martha Maria Leptospirosis Weil's disease Pulmonary hemorrhage 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.info:eu-repo/semantics/openAccessSociedade Brasileira de Medicina Tropical - SBMTRevista da Sociedade Brasileira de Medicina Tropical v.35 n.4 20022002-08-01info:eu-repo/semantics/articletext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822002000400017en10.1590/S0037-86822002000400017 |
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Silva,João José Pereira da Dalston,Marcos Olivier Carvalho,Jorge Eduardo Manhães de Setúbal,Sérgio Oliveira,Janice Mery Chiarino de Pereira,Martha Maria |
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Silva,João José Pereira da Dalston,Marcos Olivier Carvalho,Jorge Eduardo Manhães de Setúbal,Sérgio Oliveira,Janice Mery Chiarino de Pereira,Martha Maria Clinicopathological and immunohistochemical featuresof the severe pulmonary form of leptospirosis |
author_facet |
Silva,João José Pereira da Dalston,Marcos Olivier Carvalho,Jorge Eduardo Manhães de Setúbal,Sérgio Oliveira,Janice Mery Chiarino de Pereira,Martha Maria |
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Silva,João José Pereira da |
title |
Clinicopathological and immunohistochemical featuresof the severe pulmonary form of leptospirosis |
title_short |
Clinicopathological and immunohistochemical featuresof the severe pulmonary form of leptospirosis |
title_full |
Clinicopathological and immunohistochemical featuresof the severe pulmonary form of leptospirosis |
title_fullStr |
Clinicopathological and immunohistochemical featuresof the severe pulmonary form of leptospirosis |
title_full_unstemmed |
Clinicopathological and immunohistochemical featuresof the severe pulmonary form of leptospirosis |
title_sort |
clinicopathological and immunohistochemical featuresof the severe pulmonary form of leptospirosis |
description |
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. |
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Sociedade Brasileira de Medicina Tropical - SBMT |
publishDate |
2002 |
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http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822002000400017 |
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1756380258943107072 |