title: High-resolution computed tomography findings in a case of severe leptospira infection (Weil disease) complicated with Jarisch-Herxheimer reaction.
abstract: In this report, we describe a case of Weil disease. Chest x-ray and computed tomography (CT) findings showed temporary deterioration 1 day after the initiation of antibiotic treatment, and high-resolution CT findings with the patient's physical findings made us suspect pulmonary alveolar hemorrhage (PAH). We believed that the PAH had been induced by Weil disease and subsequently caused Jarisch-Herxheimer reaction. We confirmed the patient's contact history with mice, and symptoms improved immediately after starting appropriate treatments. Leptospirosis is a relatively rare cause of PAH. Therefore, the possibility of this disease should be included in the differential diagnosis, especially when high-resolution CT findings indicate PAH, and the imaging findings deteriorate rapidly after antibiotic therapy.
authors.affiliation: Department of Radiology, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan. hashi244@tokyo-med.ac.jp
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Hashimoto
authors.forename: Soichi
authors.initials: S
authors.lastname: Akata
authors.forename: Jinho
authors.initials: J
authors.lastname: Park
authors.forename: Yoshimi
authors.initials: Y
authors.lastname: Harada
authors.forename: Yoji
authors.initials: Y
authors.lastname: Hirayama
authors.forename: Junji
authors.initials: J
authors.lastname: Otaki
authors.forename: Koichi
authors.initials: K
authors.lastname: Tokuuye
mesh_terms: D000328:Adult; D000818:Animals; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use; D003937:Diagnosis, Differential; D006469:Hemoptysis / Q000000981:diagnostic imaging / Q000209:etiology; D006801:Humans; D008297:Male; D051379:Mice; D009784:Occupational Diseases / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy; D014057:Tomography, X-Ray Computed; D014895:Weil Disease / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy
chemical_list: D000900:Anti-Bacterial Agents