東京23区内で感染した重症レプトスピラ症(ワイル病)の1症例  [in Japanese] A Case of Severe Leptospirosis Infection (Weil's Disease) in Tokyo  [in Japanese]

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Author(s)

    • 増田 慶太 MASUDA Keita
    • 聖路加国際病院内科・感染症科 Division of Infectious Diseases, Department of Medicine, St. Luke's International Hospital
    • 上原 由紀 UEHARA Yuki
    • 聖路加国際病院内科・感染症科 Division of Infectious Diseases, Department of Medicine, St. Luke's International Hospital
    • 小野 宏 [他] ONO Hiroshi
    • 聖路加国際病院内科・感染症科 Division of Infectious Diseases, Department of Medicine, St. Luke's International Hospital
    • 古川 恵一 FURUKAWA Keiichi
    • 聖路加国際病院内科・感染症科 Division of Infectious Diseases, Department of Medicine, St. Luke's International Hospital

Abstract

We report a case of severe leptospirosis infection (Weilʼs disease) in Tokyo. A 54-year-old man admitted on September 14, 2006, for a 5-day inability to walk due to severe progressive bilateral leg pain, shoulder pain, and fever exhibited jaundice, conjunctival suffusion, hypoxia, andgraspingpaininthebilateralleg muscles. Laboratory findings showed severe liver damage, renal failure, leukocytosis, anemia, thrombocytopenia, elevated CRP, hyponatremia, and hypokalemia. Chest X-ray imaging showed interstitial infiltrates in the bilateral lung fields. After cefepime was initiated, he developed chills, fever, and hypotension due to Jarisch-Herxheimer reaction, necessitating respiratory support. Pulmonary hemorrhaging was also found. On hospital day 2, a urine polymerase chain reaction test for leptospira proved positive for the same base sequence as part of the leptospira gene. A microscopic agglutination test showed elevated antibody titers against <i>Leptospira interrogans</i>. Based on a diagnosis of leptospirosis, the man was treated with 2g per day of ceftriaxione for 2 weeks and recovered fully. The leptospira strain was isolated from rodents captured at his home, and we identified the same base sequence as from his urine sample. Reports shows, leptospirosis in Japan have decreased recently, but, as this case can still be seen even in Tokyo, and diagnosticians should maintain an awareness of possible significance in patients with typical findings for this disease.

Journal

  • Kansenshogaku Zasshi

    Kansenshogaku Zasshi 84(1), 59-64, 2010-01-20

    The Japanese Association for Infectious Diseases

References:  20

Cited by:  1

Codes

  • NII Article ID (NAID)
    10026893417
  • NII NACSIS-CAT ID (NCID)
    AN00047715
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • ISSN
    03875911
  • NDL Article ID
    10574863
  • NDL Source Classification
    ZS9(科学技術--医学--病理学・微生物学・寄生虫学・感染・免疫学・血清学・アレルギー)
  • NDL Call No.
    Z19-193
  • Data Source
    CJP  CJPref  NDL  J-STAGE 
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