Pulmonary Leptospirosis complicated by Acute Respiratory Distress Syndrome without Hemoptysis

ABSTRACT

Leptospirosis is an acute febrile illness that is endemic in many tropical areas and considered the most common zoonosis worldwide. It is caused by the spirochete Leptospira interrogans. The clinical manifestations may be extremely variable, ranging from flu-like symptoms with mild constitutional complains like fever, headache, myalgias, and gastrointestinal complaints to a severe presentation with the complete Weil's syndrome and sometimes with acute respiratory distress syndrome (ARDS). In Korea, the more common clinical finding is pulmonary manifestation such as cough, hemoptysis and dyspnea. Respiratory failure is an uncommon complication of leptospirosis and is due to severe pulmonary hemorrhage and/or acute respiratory distress syndrome (ARDS). A 67-year-old farmer was referred to the hospital with a history of fever, dyspnea, and confusion. She was found to have severe arterial hypoxemia but, denied blood-tinged sputum. Radiography showed widespread infiltrations over both lung fields, and hemodynamic features were consistent with ARDS. The patient recovered completely without mechanical ventilation.