EMERGENCY CASEBOOKS
Leptospirosis pulmonary haemorrhage: a diagnostic challenge
1 Queen Elizabeth Hospital NHS Trust, Woolwich, London, UK
2 Department of Microbiology, King’s College Hospital, London, UK
3 Barts and the London NHS Trust, London, UK
4 Homerton University Hospital NHS Foundation Trust, London, UK
Correspondence to:
Dr M Dall’Antonia, Queen Elizabeth Hospital NHS Trust, Stadium Road, Woolwich, London, SE184QH, UK; mdallantonia{at}nhs.net
Leptospirosis is a re-emerging zoonosis with worldwide distribution. Antibiotic treatment is available, but leptospirosis is rarely suspected due to the non-specific clinical presentation, and is also underreported due to the difficulty in confirming the diagnosis. The syndrome of leptospirosis pulmonary haemorrhage is increasingly described; it is severe and can present without the classical manifestations of Weil’s disease. We discuss two cases of leptospirosis with pulmonary haemorrhage; both our patients experienced a dramatic deterioration hours after their admission, and required emergency intubation and intensive therapy unit support. Massive haemoptysis is a life threatening complication of leptospirosis, even outside tropical areas.
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