Recreational ‘mud fever’: Leptospira interrogans induced diffuse alveolar hemorrhage and severe acute respiratory distress syndrome in a U.S. Navy seaman following ‘mud-run’ in Hawaii
A 23-year-old man with a viral-like prodrome developed sudden severe dyspnea and was found to have renal failure, anemia, shock, and diffuse alveolar hemorrhage with acute respiratory distress syndrome, requiring emergent endotracheal intubation and extracorporeal membrane oxygenation (ECMO). Travel...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2019-01-01
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| Series: | IDCases |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214250919300563 |
| _version_ | 1831794696856272896 |
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| author | Sarah A Schmalzle Ali Tabatabai Michael Mazzeffi Ann Matta Allison Hollis Marc Zubrow Keshava Rajagopal Kerri Thom Thomas Scalea |
| author_facet | Sarah A Schmalzle Ali Tabatabai Michael Mazzeffi Ann Matta Allison Hollis Marc Zubrow Keshava Rajagopal Kerri Thom Thomas Scalea |
| author_sort | Sarah A Schmalzle |
| collection | DOAJ |
| description | A 23-year-old man with a viral-like prodrome developed sudden severe dyspnea and was found to have renal failure, anemia, shock, and diffuse alveolar hemorrhage with acute respiratory distress syndrome, requiring emergent endotracheal intubation and extracorporeal membrane oxygenation (ECMO). Travel and exposure history from peripheral sources revealed that the patient had participated in a ‘mud-run’ in Hawaii two weeks prior to symptom onset. The patient was subsequently diagnosed with leptospirosis and treated with ceftriaxone and doxycycline. He was discharged on hospital day 13 with full recovery. Leptospirosis is associated with exposure to water, soil, or other matter contaminated with urine of carrier animals. It has been associated with a multitude of activities over time; most recently recreational water-based activities including ‘mud-runs’ in endemic areas have been added to the list of routes of exposure. This case underscores the importance of obtaining a thorough epidemiological exposure and travel history and being aware of areas of endemicity for life-threatening infections. Additionally, to our knowledge this is the second case of a patient in the United States treated with ECMO for leptospirosis induced pulmonary hemorrhage. Keywords: Leptospira interrogans, Leptospirosis, Leptospirosis pulmonary hemorrhage syndrome, Diffuse alveolar hemorrhage, Extra-corporeal membrane oxygenation, Mud-run |
| first_indexed | 2024-12-22T15:55:12Z |
| format | Article |
| id | doaj.art-1b98f7a0bae249d086c650d87a6e9bbc |
| institution | Directory Open Access Journal |
| issn | 2214-2509 |
| language | English |
| last_indexed | 2024-12-22T15:55:12Z |
| publishDate | 2019-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | IDCases |
| spelling | doaj.art-1b98f7a0bae249d086c650d87a6e9bbc2022-12-21T18:20:48ZengElsevierIDCases2214-25092019-01-0115Recreational ‘mud fever’: Leptospira interrogans induced diffuse alveolar hemorrhage and severe acute respiratory distress syndrome in a U.S. Navy seaman following ‘mud-run’ in HawaiiSarah A Schmalzle0Ali Tabatabai1Michael Mazzeffi2Ann Matta3Allison Hollis4Marc Zubrow5Keshava Rajagopal6Kerri Thom7Thomas Scalea8Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, United States; Division of Infectious Diseases, University of Maryland School of Medicine, Baltimore, MD, United States; University of Maryland School of Medicine, Baltimore, MD, United States; Corresponding author at: Institute of Human Virology, 725 West Lombard St, N147, Baltimore, MD, 21201, United States.University of Maryland School of Medicine, Baltimore, MD, United StatesUniversity of Maryland School of Medicine, Baltimore, MD, United StatesUniversity of Maryland School of Medicine, Baltimore, MD, United StatesUniversity of Maryland School of Medicine, Baltimore, MD, United StatesUniversity of Maryland School of Medicine, Baltimore, MD, United StatesUniversity of Texas, Houston and Memorial Hermann,Texas Medical Center, Houston, TX, United StatesDepartment of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, United StatesUniversity of Maryland School of Medicine, Baltimore, MD, United StatesA 23-year-old man with a viral-like prodrome developed sudden severe dyspnea and was found to have renal failure, anemia, shock, and diffuse alveolar hemorrhage with acute respiratory distress syndrome, requiring emergent endotracheal intubation and extracorporeal membrane oxygenation (ECMO). Travel and exposure history from peripheral sources revealed that the patient had participated in a ‘mud-run’ in Hawaii two weeks prior to symptom onset. The patient was subsequently diagnosed with leptospirosis and treated with ceftriaxone and doxycycline. He was discharged on hospital day 13 with full recovery. Leptospirosis is associated with exposure to water, soil, or other matter contaminated with urine of carrier animals. It has been associated with a multitude of activities over time; most recently recreational water-based activities including ‘mud-runs’ in endemic areas have been added to the list of routes of exposure. This case underscores the importance of obtaining a thorough epidemiological exposure and travel history and being aware of areas of endemicity for life-threatening infections. Additionally, to our knowledge this is the second case of a patient in the United States treated with ECMO for leptospirosis induced pulmonary hemorrhage. Keywords: Leptospira interrogans, Leptospirosis, Leptospirosis pulmonary hemorrhage syndrome, Diffuse alveolar hemorrhage, Extra-corporeal membrane oxygenation, Mud-runhttp://www.sciencedirect.com/science/article/pii/S2214250919300563 |
| spellingShingle | Sarah A Schmalzle Ali Tabatabai Michael Mazzeffi Ann Matta Allison Hollis Marc Zubrow Keshava Rajagopal Kerri Thom Thomas Scalea Recreational ‘mud fever’: Leptospira interrogans induced diffuse alveolar hemorrhage and severe acute respiratory distress syndrome in a U.S. Navy seaman following ‘mud-run’ in Hawaii IDCases |
| title | Recreational ‘mud fever’: Leptospira interrogans induced diffuse alveolar hemorrhage and severe acute respiratory distress syndrome in a U.S. Navy seaman following ‘mud-run’ in Hawaii |
| title_full | Recreational ‘mud fever’: Leptospira interrogans induced diffuse alveolar hemorrhage and severe acute respiratory distress syndrome in a U.S. Navy seaman following ‘mud-run’ in Hawaii |
| title_fullStr | Recreational ‘mud fever’: Leptospira interrogans induced diffuse alveolar hemorrhage and severe acute respiratory distress syndrome in a U.S. Navy seaman following ‘mud-run’ in Hawaii |
| title_full_unstemmed | Recreational ‘mud fever’: Leptospira interrogans induced diffuse alveolar hemorrhage and severe acute respiratory distress syndrome in a U.S. Navy seaman following ‘mud-run’ in Hawaii |
| title_short | Recreational ‘mud fever’: Leptospira interrogans induced diffuse alveolar hemorrhage and severe acute respiratory distress syndrome in a U.S. Navy seaman following ‘mud-run’ in Hawaii |
| title_sort | recreational mud fever leptospira interrogans induced diffuse alveolar hemorrhage and severe acute respiratory distress syndrome in a u s navy seaman following mud run in hawaii |
| url | http://www.sciencedirect.com/science/article/pii/S2214250919300563 |
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