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

Testing for acute and chronic HIV, hepatitis B, and hepatitis C was negative. No respiratory viruses were identified by PCR from nasal swab or bronchoalveolar lavage (BAL). Cultures of blood and BAL specimens for bacterial and fungal pathogens were also negative. Other negative tests included: thick and thin blood smears for malaria, Legionella and Streptococcus pneumoniae urinary antigens, serum CMV PCR, Lyme IgM, and IgG, IgM, and PCR for Ehrlichia chaffeensis and Anaplasma phagocytophilum. Mycoplasma IgG was positive, but IgM and PCR were not. Hantavirus IgG was also positive with negative IgM.