The relative importance of the renal and hepatic lesions in experimental leptospirosis icterohæmorrhagica

Wylie, J. A. H.

doi:10.1002/path.1700580304

Cited by 14 publications

(1 citation statement)

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“…Passend dazu konnte in unserem Fall serologisch erhö hte Antikö rpertiter gegen L. canicola, L. icterohä morrhagiae und L. sejroe nachgewiesen werden. Die Pathogenese der Erkrankung ist nach wie vor nicht geklä rt, jedoch wird von vielen Auto-ren ein durch Bakterientoxine bedingter endothelialer Zelluntergang an den Anfang der pathogenetischen Kette gestellt, welcher zu einer lokalen Gewebshypoxie fü hren soll [7,8,20]. In diesem Zusammenhang stellt sich bei unserem Fall die Frage, inwieweit die beschriebenen Herzrythmusstö rungen mit Asystolie des Patienten auf ein solches lokales hypoxisches Ereignis innerhalb des Myokards zurü ckgefü hrt werden kö nnen oder aber andere Mechanismen insbesondere eine pneumoniebedingte Hypoxie sowie die Anä mie dafü r verantwortlich gemacht werden mü ssen.…”

Section: Introductionunclassified

Weil'sche Erkrankung und nekrotisierende Herpespneumonie als Todesursache bei einem 39 Jahre alt gewordenen Kanalarbeiter

et al. 1996

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Acute leptospirosis in Europe (Weil's disease) is a rare and in more than 90% of the cases undiagnosed febrile, self-limited disease. We report the case of a 39-year-old sewerage worker, who was admitted to our hospital with fever, jaundice, pain in his calves and acute renal failure. Serology revealed elevated antibody titers against Leptospira canicola, L. icterhaemorrhagica and L. sejroe. The patient developed disseminated intravascular coagulation (DIC) with diffuse gastrointestinal bleeding due to thrombocytopenia. The ECG showed atrial fibrillation with irregularly irregular rhythm. Cardiac arrest developed, most likely due to hypoxia, with a drop in the blood pressure. Despite immediate resuscitation efforts the patient developed severe hypoxic brain damage and died a few days later. Autopsy disclosed histologic signs of a generalized leptospiral infection, signs of shock and within the lungs a necrotizing herpes simplex virus pneumonia causing the death of the patient. The virus pneumonia most probably was caused by retrograde canalicular dissemination of oral secretions since herpetic tracheitis and esophagitis were found and herpetic lesions were readily identified on the lips and tongue. A medical opinion asked for by the professional association having liability for occupational safety and insurance was given, the disease being recognized as an occupational disease.

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Section: Introductionunclassified