Case report: Leptospirosis with multi-organ failure complicated by massive upper gastrointestinal bleeding in a non-epidemic setting with successful management
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 the tr...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-03-01
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| Series: | Frontiers in Surgery |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fsurg.2023.1131659/full |
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| author | Mariam Thalji Hanan Qunibi Loai Muhtasib Hasan Hroob Ashraf Al-Zughayyar Rafiq Salhab Yousef Abu Asbeh |
| author_facet | Mariam Thalji Hanan Qunibi Loai Muhtasib Hasan Hroob Ashraf Al-Zughayyar Rafiq Salhab Yousef Abu Asbeh |
| author_sort | Mariam Thalji |
| collection | DOAJ |
| description | 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 the triad of acute renal injury, jaundice, and hemorrhages. Herein, we reported a case of a 28-year-old male transferred to our intensive care unit due to severe leptospirosis with diffuse alveolar hemorrhage, cholestatic jaundice, acute respiratory distress, and renal injury. The patient was successfully managed with appropriate antimicrobial treatment and other supportive management, including mechanical ventilation, vasopressor, and corticosteroid therapy. Ten days after admission, the patient unexpectedly developed uncontrollable massive upper gastrointestinal bleeding, requiring immediate surgical interventions. Splenectomy, partial gastrectomy, along with gastro-esophageal anastomosis were performed. Following a prolonged hospitalization, the patient fully recovered and was discharged home with excellent clinical outcomes. This fulminant leptospirosis case described here should assist in informing medical professionals of the clinical significance of this serious, occasionally fatal illness. 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 hemorrhage, may happen despite their rarity. In such cases, adopting an integrated multidisciplinary team approach is essential to prevent complications and reduce mortality. |
| first_indexed | 2024-04-10T05:32:05Z |
| format | Article |
| id | doaj.art-1f446fc79f9949bb840fc2508ebd184e |
| institution | Directory Open Access Journal |
| issn | 2296-875X |
| language | English |
| last_indexed | 2024-04-10T05:32:05Z |
| publishDate | 2023-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Surgery |
| spelling | doaj.art-1f446fc79f9949bb840fc2508ebd184e2023-03-07T05:46:59ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2023-03-011010.3389/fsurg.2023.11316591131659Case report: Leptospirosis with multi-organ failure complicated by massive upper gastrointestinal bleeding in a non-epidemic setting with successful managementMariam Thalji0Hanan Qunibi1Loai Muhtasib2Hasan Hroob3Ashraf Al-Zughayyar4Rafiq Salhab5Yousef Abu Asbeh6Faculty of Medicine, Al-Quds University, Jerusalem, PalestineFaculty of Medicine, Al-Quds University, Jerusalem, PalestineMedical Intensive Care Unit, Al-Ahli Hospital, Hebron, PalestineMedical Intensive Care Unit, Al-Ahli Hospital, Hebron, PalestineMedical Intensive Care Unit, Al-Ahli Hospital, Hebron, PalestineGenaral Surgery Department, Al-Ahli Hospital, Hebron, PalestineThoracic Surgery Unit, Al-Ahli Hospital, Hebron, PalestineLeptospirosis 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 the triad of acute renal injury, jaundice, and hemorrhages. Herein, we reported a case of a 28-year-old male transferred to our intensive care unit due to severe leptospirosis with diffuse alveolar hemorrhage, cholestatic jaundice, acute respiratory distress, and renal injury. The patient was successfully managed with appropriate antimicrobial treatment and other supportive management, including mechanical ventilation, vasopressor, and corticosteroid therapy. Ten days after admission, the patient unexpectedly developed uncontrollable massive upper gastrointestinal bleeding, requiring immediate surgical interventions. Splenectomy, partial gastrectomy, along with gastro-esophageal anastomosis were performed. Following a prolonged hospitalization, the patient fully recovered and was discharged home with excellent clinical outcomes. This fulminant leptospirosis case described here should assist in informing medical professionals of the clinical significance of this serious, occasionally fatal illness. 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 hemorrhage, may happen despite their rarity. In such cases, adopting an integrated multidisciplinary team approach is essential to prevent complications and reduce mortality.https://www.frontiersin.org/articles/10.3389/fsurg.2023.1131659/fullleptospirosisweil’s diseaseacute kidney injuryalveolar hemorrhagemultiorgan failureupper G.I. bleeding |
| spellingShingle | Mariam Thalji Hanan Qunibi Loai Muhtasib Hasan Hroob Ashraf Al-Zughayyar Rafiq Salhab Yousef Abu Asbeh Case report: Leptospirosis with multi-organ failure complicated by massive upper gastrointestinal bleeding in a non-epidemic setting with successful management Frontiers in Surgery leptospirosis weil’s disease acute kidney injury alveolar hemorrhage multiorgan failure upper G.I. bleeding |
| title | Case report: Leptospirosis with multi-organ failure complicated by massive upper gastrointestinal bleeding in a non-epidemic setting with successful management |
| title_full | Case report: Leptospirosis with multi-organ failure complicated by massive upper gastrointestinal bleeding in a non-epidemic setting with successful management |
| title_fullStr | Case report: Leptospirosis with multi-organ failure complicated by massive upper gastrointestinal bleeding in a non-epidemic setting with successful management |
| title_full_unstemmed | Case report: Leptospirosis with multi-organ failure complicated by massive upper gastrointestinal bleeding in a non-epidemic setting with successful management |
| title_short | Case report: Leptospirosis with multi-organ failure complicated by massive upper gastrointestinal bleeding in a non-epidemic setting with successful management |
| title_sort | case report leptospirosis with multi organ failure complicated by massive upper gastrointestinal bleeding in a non epidemic setting with successful management |
| topic | leptospirosis weil’s disease acute kidney injury alveolar hemorrhage multiorgan failure upper G.I. bleeding |
| url | https://www.frontiersin.org/articles/10.3389/fsurg.2023.1131659/full |
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