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Weekly Chest CasesArchive of Old Cases

Case No : 20 Date 1998-03-16

  • Courtesy of Jung-Gi Im, M.D., Joon Beom Seo, M.D., Jae-Woo Song, M.D. / Seoul National University Hospital, Boramae Hospital
  • Age/Sex 56 / M
  • Chief Complaintfever with myalgia for 3 days
  • Figure 1
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CPA 1 (13 Sep. 1997)

Diagnosis With Brief Discussion

Diagnosis
Leptospirosis
Radiologic Findings
He is a farmer and lives in Paju-gun, Kyoung-gi-do.
Leptospirosis, caused by the spirochete Leptospira, is an acute, febrile, systemic diseass comprising fever, jaundice, hemorrhage, nephritis, and meningitis. Leptospirosis follows contact with contaminated water or tissues of infected animals. Leptospirosis is common in tropical and subtropical climates, particularly in the far East.
Pneumonia occurs in one fifth to two thirds of patients with leptospirosis. Im et al reviewd the chest radiographic findings in 37 patients of 58 serologically proven leptospirosis, who had the positive radiographic findings, with pathologic correlation by experimental study (AJR 1989; 152: 955-959). Three radiographic patterns were evident: (1) 21 (57%) of the 37 patients had small nodular desnsities, (2) six (16%) had large confluent areas of consolidation, and (3) 10 (27%) had diffuse, ill-defined, ground-glass density. Serial radiographs showed a tendency for the nodular pattern to be followed by confluent consolidation and/or ground-glass opacity, as this case. Abnormalites were bilateral, nonlobar in all cases, and had a marked tendency toward peripheral predominance. The pulmonary abnoramlities were due to petecheal hemorrhage, which progressed to large confluent areas of hemorrhage on experimental study. Hilar and mediastinal adenopathy does not appear to be a feature.
Brief Review
References
Keywords
Lung, Infection, other infection,

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