High-resolution Computed Tomography Findings in a Case of Severe Leptospira Infection (Weil Disease) Complicated With Jarisch-Herxheimer Reaction
High-resolution Computed Tomography Findings in a Case of Severe Leptospira Infection (Weil Disease) Complicated With Jarisch-Herxheimer Reaction
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DOI：
10.1097/rti.0b013e318231535b
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发表时间：
2012-01-01
影响因子：
3.3
通讯作者：
Tokuuye, Koichi
中科院分区：
文献类型：
--
作者：
Hashimoto, Tsuyoshi;Akata, Soichi;Tokuuye, Koichi
在这份报告中，我们描述了一个案件韦伊病。开始抗生素治疗后1天，胸部X线和计算机断层扫描（CT）结果显示暂时恶化，高分辨率CT结果与患者的体格检查结果使我们怀疑肺泡出血（PAH）。我们认为PAH是由Weil病引起的，并随后引起了Jauch-Herxheimer反应。我们确认了患者与小鼠的接触史，在开始适当的治疗后症状立即改善。钩端螺旋体病是一种相对罕见的PAH病因。因此，应将这种疾病的可能性纳入鉴别诊断，特别是当高分辨率CT结果表明PAH，并且抗生素治疗后影像学结果迅速恶化时。
In this report, we describe a case of Weil disease. Chest x-ray and computed tomography (CT) findings showed temporary deterioration 1 day after the initiation of antibiotic treatment, and high-resolution CT findings with the patient's physical findings made us suspect pulmonary alveolar hemorrhage (PAH). We believed that the PAH had been induced by Weil disease and subsequently caused Jarisch-Herxheimer reaction. We confirmed the patient's contact history with mice, and symptoms improved immediately after starting appropriate treatments. Leptospirosis is a relatively rare cause of PAH. Therefore, the possibility of this disease should be included in the differential diagnosis, especially when high-resolution CT findings indicate PAH, and the imaging findings deteriorate rapidly after antibiotic therapy.