title: Leptospirosis presenting as atypical pneumonia, respiratory failure and pyogenic meningitis.
abstract: A 20-year-old man who looked after a pack of hounds was admitted with a short history of headache, fever, haemoptysis and muscle cramps. Investigations showed type I respiratory failure with diffuse pneumonitis, pyogenic meningitis and raised liver enzymes. Leptospirosis was suspected and treated with the appropriate antibiotics leading to a full recovery. The diagnosis was confirmed by a titre of I/2560 to Leptospira icterohaemorrhagiae. The case illustrates an unusual presentation of this infection and argues for early antibiotic treatment.
authors.affiliation: Department of Medicine, Blackburn Royal Infirmary, Lancashire, U.K.
authors.forename: F S
authors.initials: FS
authors.lastname: Alani
authors.forename: M P
authors.initials: MP
authors.lastname: Mahoney
authors.forename: L P
authors.initials: LP
authors.lastname: Ormerod
authors.forename: P A
authors.initials: PA
authors.lastname: Wright
authors.forename: M
authors.initials: M
authors.lastname: Garrues
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D006801:Humans; D007921:Leptospira interrogans; D007922:Leptospirosis / Q000175:diagnosis* / Q000188:drug therapy; D008297:Male; D016920:Meningitis, Bacterial / Q000175:diagnosis* / Q000188:drug therapy; D011014:Pneumonia / Q000175:diagnosis* / Q000188:drug therapy; D012131:Respiratory Insufficiency / Q000175:diagnosis* / Q000188:drug therapy
chemical_list: D000900:Anti-Bacterial Agents