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A Patient with Severe Leptospirosis Treated with Cytokine Removal and High-Dose Corticosteroids

Leptospirosis is an ubiquitous zoonosis with significant morbidity and mortality. Approximately 10 percent of human infections evolve into a severe form, with a sepsis-like disease, multiorgan failure, and significant mortality rate. The cornerstone of treatment of severe disease is antibiotic thera...

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Autores principales: Fluher, Jure, Cestar, Iva, Jerenec, Katja, Kalamar, Žiga, Baklan, Zvonko, Markota, Andrej
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9498765/
https://www.ncbi.nlm.nih.gov/pubmed/36136818
http://dx.doi.org/10.3390/idr14050068
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author Fluher, Jure
Cestar, Iva
Jerenec, Katja
Kalamar, Žiga
Baklan, Zvonko
Markota, Andrej
author_facet Fluher, Jure
Cestar, Iva
Jerenec, Katja
Kalamar, Žiga
Baklan, Zvonko
Markota, Andrej
author_sort Fluher, Jure
collection PubMed
description Leptospirosis is an ubiquitous zoonosis with significant morbidity and mortality. Approximately 10 percent of human infections evolve into a severe form, with a sepsis-like disease, multiorgan failure, and significant mortality rate. The cornerstone of treatment of severe disease is antibiotic therapy, with the aims of preventing complications, reducing the duration of disease, and ultimately reducing mortality. The initiation of antibiotic chemotherapy can precipitate a febrile inflammatory reaction, also known as a Jarisch–Herxheimer reaction. We present a case report of a patient with severe leptospirosis, complicated by multiorgan failure with severe circulatory failure of distributive and cardiogenic etiology, possibly as a consequence of the Jarisch–Herxheimer reaction. The patient was treated with antimicrobial therapy and other supportive measures along with high-dose corticosteroid therapy, long-term mechanical ventilation, high-dose vasopressor therapy, and continuous veno-venous hemodiafiltration with extracorporeal cytokine removal.With this case, we would like to report on a patient presenting with two neglected diseases in our part of Europe, who was treated with novel therapeutic strategies.
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spelling pubmed-94987652022-09-23 A Patient with Severe Leptospirosis Treated with Cytokine Removal and High-Dose Corticosteroids Fluher, Jure Cestar, Iva Jerenec, Katja Kalamar, Žiga Baklan, Zvonko Markota, Andrej Infect Dis Rep Case Report Leptospirosis is an ubiquitous zoonosis with significant morbidity and mortality. Approximately 10 percent of human infections evolve into a severe form, with a sepsis-like disease, multiorgan failure, and significant mortality rate. The cornerstone of treatment of severe disease is antibiotic therapy, with the aims of preventing complications, reducing the duration of disease, and ultimately reducing mortality. The initiation of antibiotic chemotherapy can precipitate a febrile inflammatory reaction, also known as a Jarisch–Herxheimer reaction. We present a case report of a patient with severe leptospirosis, complicated by multiorgan failure with severe circulatory failure of distributive and cardiogenic etiology, possibly as a consequence of the Jarisch–Herxheimer reaction. The patient was treated with antimicrobial therapy and other supportive measures along with high-dose corticosteroid therapy, long-term mechanical ventilation, high-dose vasopressor therapy, and continuous veno-venous hemodiafiltration with extracorporeal cytokine removal.With this case, we would like to report on a patient presenting with two neglected diseases in our part of Europe, who was treated with novel therapeutic strategies. MDPI 2022-08-27 /pmc/articles/PMC9498765/ /pubmed/36136818 http://dx.doi.org/10.3390/idr14050068 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Fluher, Jure
Cestar, Iva
Jerenec, Katja
Kalamar, Žiga
Baklan, Zvonko
Markota, Andrej
A Patient with Severe Leptospirosis Treated with Cytokine Removal and High-Dose Corticosteroids
title A Patient with Severe Leptospirosis Treated with Cytokine Removal and High-Dose Corticosteroids
title_full A Patient with Severe Leptospirosis Treated with Cytokine Removal and High-Dose Corticosteroids
title_fullStr A Patient with Severe Leptospirosis Treated with Cytokine Removal and High-Dose Corticosteroids
title_full_unstemmed A Patient with Severe Leptospirosis Treated with Cytokine Removal and High-Dose Corticosteroids
title_short A Patient with Severe Leptospirosis Treated with Cytokine Removal and High-Dose Corticosteroids
title_sort patient with severe leptospirosis treated with cytokine removal and high-dose corticosteroids
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9498765/
https://www.ncbi.nlm.nih.gov/pubmed/36136818
http://dx.doi.org/10.3390/idr14050068
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