| Leptospirosis (Weil's disease) in Augsburg | |
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MedLine Citation:
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PMID: 20358494 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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B Walter; B Wein; M Bittinger; H Messmann |
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Publication Detail:
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Type: Case Reports; English Abstract; Journal Article Date: 2010-03-31 |
Journal Detail:
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Title: Deutsche medizinische Wochenschrift (1946) Volume: 135 ISSN: 1439-4413 ISO Abbreviation: Dtsch. Med. Wochenschr. Publication Date: 2010 Apr |
Date Detail:
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Created Date: 2010-04-01 Completed Date: 2010-04-14 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0006723 Medline TA: Dtsch Med Wochenschr Country: Germany |
Other Details:
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Languages: ger Pagination: 675-8 Citation Subset: IM |
Copyright Information:
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Georg Thieme Verlag KG Stuttgart, New York. |
Affiliation:
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Medizinische Klinik III, Zentralklinikum Augsburg, Augsburg. benjamin.walter@klinikum-augsburg.de |
Vernacular Title:
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Leptospirose (Morbus Weil) in Augsburg. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Diagnosis, Differential Fatal Outcome Female Germany Humans Jaundice / etiology Kidney Failure, Acute / etiology Male Middle Aged Thrombocytopenia / etiology Travel Weil Disease / diagnosis*, mortality, transmission |
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