Successful Treatment of Pulmonary Hemorrhage Associated with Leptospirosis and Scrub Typhus Coinfection by Early Plasma Exchange

Leptospirosis and scrub typhus coinfections have been reported in up to 41% of agricultural workers with acute leptospirosis in Thailand, but only sporadically in Taiwan. Because of the nonspecific clinical presentations, it is difficult to differentiate patients with coinfections from leptospirosis...

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Bibliographic Details
Published in:Journal of the Formosan Medical Association 2007, Vol.106 (2), p.S1-S6
Main Authors: Chen, Yun-Sung, Cheng, Shih-Lung, Wang, Hao-Chien, Yang, Pan-Chyr
Format: Article
Language:English
Subjects:
Internal Medicine
leptospirosis
moxifloxacin
plasma exchange
pulmonary hemorrhage
scrub typhus
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Summary:Leptospirosis and scrub typhus coinfections have been reported in up to 41% of agricultural workers with acute leptospirosis in Thailand, but only sporadically in Taiwan. Because of the nonspecific clinical presentations, it is difficult to differentiate patients with coinfections from leptospirosis alone. However, failure to identify coinfection may lead to mortality if inappropriate antibiotics are used. We report a 31-year-old man coinfected with leptospirosis and scrub typhus, which manifested as diffuse alveolar hemorrhage and acute renal failure mimicking pulmonary-renal syndrome. The patient was treated by early plasma exchange and a 7-day course of moxifloxacin therapy. Both pulmonary hemorrhage and hypoxemia resolved substantially on the 4th day of hospitalization. He had a complete recovery from the disease after 6 weeks of hospitalization. [ J Formos Med Assoc 2007;106(2 Suppl):S1-S6]
ISSN:0929-6646
1876-0821
DOI:10.1016/S0929-6646(09)60344-2