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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...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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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. |
format | Online Article Text |
id | pubmed-9498765 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
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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