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.

Bibliographic Details

Main Authors:	Silva,João José Pereira da, Dalston,Marcos Olivier, Carvalho,Jorge Eduardo Manhães de, Setúbal,Sérgio, Oliveira,Janice Mery Chiarino de, Pereira,Martha Maria
Format:	Digital revista
Language:	English
Published:	Sociedade Brasileira de Medicina Tropical - SBMT 2002
Online Access:	http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822002000400017
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