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

By the patient's sixth day on ECMO he had a significant radiographic and clinical improvement with no further evidence of DAH. He was decannulated from ECMO and endotracheally extubated the following morning. Total time on ECMO was 126 h. Two days later he was discharged from the intensive care unit and he left the hospital shortly after. At follow up one month later, patient reported being weak compared to his baseline (could 'only' perform 20 push-ups). Following a three to five month process of medical clearance, the patient was able to return to active duty for the US Navy (Fig. 3) . He notes that on hikes in HI he routinely warns people he encounters of the risk of leptospirosis.