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Weil's disease.

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Humans↗

[Leptospira infected rat population as probable cause of a fatal case of Weil's disease].

In the summer of 1992 a patient died of a leptospiral infection which he probably had contracted while he was swimming in an artificial lake in the region of Tübingen/Reutlingen. Regarding the epidemiological role of leptospirosis the rodent population was investigated, because rats and mice were often seen in the surrounding area. 11 rats and 20 mice could be trapped. From their urine or kidneys two leptospiral serovars were isolated: Serovar copenhageni from Rattus norvegicus and serovar saxkoebing from Clethrionomys glareolus. Leptospiral antibody titers were not detected in one of these infected animals. It may be supposed that the Leptospira interrogans serovar copenhageni out of the Serogroup Icterohaemorrhagiae had caused the leptospiral infection of the patient.

Animals↗

Weil's disease: report of 12 cases.

The epidemiological distribution and clinical features of 12 cases of Weil's disease from Turkey, are reviewed. The disease is most common in male farmers from rural areas. Myalgia and jaundice were recorded in all patients. Signs included vomiting in 9 patients, haemorrhages in 6, and renal function was impaired in 6. Creatine phosphokinase levels were found above normal limits in 75% of the cases. Leptospires were demonstrated with dark-field microscopy in the blood of 9 and in the urine of 5 of these patients. The diagnosis was confirmed with microscopic agglutination test (MAT) as well as with ELISA. Ig M antibodies were detected in 11 (92%) of the patients and is an accurate marker for acute leptospirosis. Penicillin was used for therapy and the outcome was favorable in 10 patients. Two patients died. It should be kept in mind that leptospirosis is an extremely severe disease which requires appropriate examinations at the right moment.

Adult↗

[Weil's disease and necrotizing herpes pneumonia as the cause of death of a 39-year-old sewage drain worker].

Acute leptospirosis in Europe (Weil's disease) is a rare and in more than 90% of the cases undiagnosed febrile, self-limited disease. We report the case of a 39-year-old sewerage worker, who was admitted to our hospital with fever, jaundice, pain in his calves and acute renal failure. Serology revealed elevated antibody titers against Leptospira canicola, L. icterhaemorrhagica and L. sejroe. The patient developed disseminated intravascular coagulation (DIC) with diffuse gastrointestinal bleeding due to thrombocytopenia. The ECG showed atrial fibrillation with irregularly irregular rhythm. Cardiac arrest developed, most likely due to hypoxia, with a drop in the blood pressure. Despite immediate resuscitation efforts the patient developed severe hypoxic brain damage and died a few days later. Autopsy disclosed histologic signs of a generalized leptospiral infection, signs of shock and within the lungs a necrotizing herpes simplex virus pneumonia causing the death of the patient. The virus pneumonia most probably was caused by retrograde canalicular dissemination of oral secretions since herpetic tracheitis and esophagitis were found and herpetic lesions were readily identified on the lips and tongue. A medical opinion asked for by the professional association having liability for occupational safety and insurance was given, the disease being recognized as an occupational disease.

Adult↗

A case of Weil's disease requiring steroid therapy for thrombocytopenia and bleeding.

A young New Hampshire man was recently treated for severe Weil's disease caused by serologically diagnosed Leptospira icterohemorrhagiae. In addition to severe renal failure and hepatic disease, his case featured marked thrombocytopenia with multiple evidences of bleeding. A course of steroid therapy was associated with improved platelet counts and amelioration of his hemorrhagic diathesis.

Adrenal Cortex Hormones↗