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Leptospirosis (Weil's disease) in Augsburg
MedLine Citation:
PMID:  20358494     Owner:  NLM     Status:  MEDLINE    
HISTORY: Three unrelated patients presented within three months at the Central Hospital of Augsburg, Southern Germany, with jaundice of initially unknown etiology. Patient (Pt.) 1, a 51-year old man was admitted with a history of nausea, vomiting, diarrhea, jaundice and anuria. Pt. 2 was a 58-year-old man who had fever and shivering, and had developed jaundice after a fishing-trip to Canada. Pt. 3 was a 66-year-old woman who presented at the Emergency Unit with recently developed jaundice and pain in the right lateral epigastric area. INVESTIGATIONS: Laboratory results showed elevated levels for bilirubin, CK, BUN, creatinine and low thrombocytes in patients 1 and 2. An elevated lipase level was found in Pt 1, while Pt 3 had an elevated bilirubin and thrombocytopenia. In Pt 1 and 2 active leptospirosis was diagnosed by serological tests. The third patient showed a subsided leptospirosis, the jaundice having been due to a histologically confirmed drug-associated hepatitis. TREATMENT AND COURSE: Patients 1 and 2, who had active disease, showed the full-blown clinical picture of Weil's disease with jaundice, renal failure and thrombocytopenia. After administration of penicillin G and a third generation cephalosporin (ceftriaxone), respectively, all symptoms disappeared. The 66-year-old woman (Pt 3) developed pneumonia and died of multiple organ failure. CONCLUSION: Leptospirosis is an important differential diagnosis in patients with recent onset of jaundice and acute renal failure. A detailed history may offer the crucial hint and serological tests provide proof. The clinical outcome mainly depends on starting antimicrobial therapy with penicillin G or a third generation cephalosporin as soon as practicable.
B Walter; B Wein; M Bittinger; H Messmann
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Publication Detail:
Type:  Case Reports; English Abstract; Journal Article     Date:  2010-03-31
Journal Detail:
Title:  Deutsche medizinische Wochenschrift (1946)     Volume:  135     ISSN:  1439-4413     ISO Abbreviation:  Dtsch. Med. Wochenschr.     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-04-01     Completed Date:  2010-04-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0006723     Medline TA:  Dtsch Med Wochenschr     Country:  Germany    
Other Details:
Languages:  ger     Pagination:  675-8     Citation Subset:  IM    
Copyright Information:
Georg Thieme Verlag KG Stuttgart, New York.
Medizinische Klinik III, Zentralklinikum Augsburg, Augsburg.
Vernacular Title:
Leptospirose (Morbus Weil) in Augsburg.
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MeSH Terms
Diagnosis, Differential
Fatal Outcome
Jaundice / etiology
Kidney Failure, Acute / etiology
Middle Aged
Thrombocytopenia / etiology
Weil Disease / diagnosis*,  mortality,  transmission

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