Co–Infection: Weil’s Syndrome with Hepatitis B Infection- A Diagnostic and Therapeutic Hitch

Abstract

A 48 -year -old female, resident of Kasargod, rural area in Dakshina Kannada,India, was admitted with complaints of high grade fever with chills, epigastric pain and cough with expectoration since 2 weeks and oliguria since 2 days. General examination revealed fever, icterus, conjunctival suffusion, pedal edema and facial puffiness. On systemic examination, there was diffuse tenderness and guarding over the abdomen, bilateral coarse crepitations over the chest region. Abdominal ultrasound revealed hepatomegaly, bulky spleen and right basal consolidation. X-Ray findings of chest were suggestive of pulmonary haemorrhage. Blood investigations were within normal range. Blood and urine cultures were sterile. RA factor was 376IU/ml, ASO titre was 202.3IU/ml, ESR-51mm.The patient was shifted to intensive care unit after two days of admission in the view of decreasing renal functions, tachypnoea and metabolic acidosis. Peripheral smear for malaria and for serology for dengue were negative. Patient was reactive for HBsAg by both rapid screening and ELISA ( HEPLISA J.Mitra

Acute Kidney Injury and Acute Liver Failure in Leptospira Infection and Weil’s Syndrome

“…Clinically, it presents as an icteric fever and myalgia, with multi-organ involvement (9). In addition to being caused by co-infections with other liverdamaging agents (30), fulminant hepatic failure appears to be linked to endothelial damage in the liver sinuses (31) observed a decrease in the expression of ATPase of NHE 3, aquaporin-1, and α-Na (+) K (+) ATPase in the cells of the proximal convoluted tubule. The expression of aquaporin-1 was preserved along the thin descending limb of Henle's loop in the outer medulla.…”