Author: Schmalzle, Sarah A; Tabatabai, Ali; Mazzeffi, Michael; Matta, Ann; Hollis, Allison; Zubrow, Marc; Rajagopal, Keshava; Thom, Kerri; Scalea, Thomas
Title: 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 Document date: 2019_3_23
ID: 6gm763j5_7
Snippet: The patient was empirically started on high dose intravenous steroids for possible vasculitis; extensive evaluation for rheumatologic disease excluded granulomatosis with polyangitis (Wegener's syndrome), anti-glomerular basement membrane disease (formerly 'Goodpastures' syndrome), systemic lupus erythematosus, antiphospholipid antibody syndrome, systemic sclerosis, and mixed connective tissue disease. Lung biopsy was not pursued due to high risk.....
Document: The patient was empirically started on high dose intravenous steroids for possible vasculitis; extensive evaluation for rheumatologic disease excluded granulomatosis with polyangitis (Wegener's syndrome), anti-glomerular basement membrane disease (formerly 'Goodpastures' syndrome), systemic lupus erythematosus, antiphospholipid antibody syndrome, systemic sclerosis, and mixed connective tissue disease. Lung biopsy was not pursued due to high risk of bleeding while on ECMO. Fig. 1. (a) unremarkable CXR on initial presentation; (b) CXR upon re-presentation with developing interstitial opacities.
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