Recreational ‘mud fever’: Leptospira interrogans induced diffuse alveolar hemorrhage and severe acute respiratory distress syndrome in a U.S. Navy seaman following ‘mud-run’ in Hawaii

Schmalzle, Sarah A; Tabatabai, Ali; Mazzeffi, Michael; Matta, Ann; Hollis, Allison; Zubrow, Marc; Rajagopal, Keshava; Thom, Kerri; Scalea, Thomas

Use of ECMO in leptospirosis had been reported only thrice through the year 2010 but 15 times (including this case) since 2015 [17] [18] [19] . The case described here is the second report of use of ECMO for leptospirosis in the United States, both contracted outside of the contiguous United States. Only one of these 18 patients died. Comparatively, a recent description of LPHS patients in an endemic region revealed a mortality rate of 65.5% with standard care [20] . It therefore would be reasonable to extrapolate that the use of ECMO in severely ill patients with LPHS may reduce mortality. The timely coordination of care between the community hospital and the tertiary care center intensive care unit with ECMO capability played a major role in the successful outcome in this case.