Weekly Chest CasesImaging Conference Cases

Case No : 1

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  • Age/Sex 45 / M
  • Case Title 45-year-old man with hemoptsis, fever and chill for 1 week
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Diagnosis With Brief Discussion

Courtesy
Samsung Medical Center
Discussion
- Ubiquitous zoonotic disease
- Systemic infection usually producing fever with hepatorenal involvement, meningoencephalitis, and hemorrhage
- Pulmonary involvement (59.1%) with hemoptysis (37.4%)
- Radiological evidence of bilateral reticulonodular infiltration (60-91%) after 3-7 days symptom onset; progresses into extensive confluent consolidation
- Brochoscopy explorations with bronchoalveolar lavage: intra-alveolar hemorrhage, probably due to extensive area of endothelial damage by the toxins produced by leptospira rather than coagulation abnormality
- Prognosis: usually resolves in 5-10 days, occasionally develops ARDS
- Treatment: high dose glucocorticoid should be given as early as possible after the onset of dyspnea to all the patients with pulmonary involvement
Keywords
Lung, Infection, Bacterial infection,
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