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_15
Snippet: The protean nature of most cases of leptospirosis, coupled with notoriously poor sensitivity and specificity of IgM for any infection make this diagnosis difficult to establish at initial time of presentation. Even in HI, the majority of cases are not suspected at presentation [5] . Convalescent sera and PCR can confirm diagnosis [14] , but a high index of clinical suspicion is crucial to provide early and appropriate empiric antibiotics. In this.....
Document: The protean nature of most cases of leptospirosis, coupled with notoriously poor sensitivity and specificity of IgM for any infection make this diagnosis difficult to establish at initial time of presentation. Even in HI, the majority of cases are not suspected at presentation [5] . Convalescent sera and PCR can confirm diagnosis [14] , but a high index of clinical suspicion is crucial to provide early and appropriate empiric antibiotics. In this case, the presence of DAH significantly narrowed the differential diagnosis, and exposure to mud and fresh water in HI were important epidemiologic clues that suggested Leptospirosis. Treatment should include penicillin, doxycycline, or a third generation cephalosporin [15, 16] ; this patient received ceftriaxone and doxycycline for 10 days and did recover.
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