title: Severe leptospirosis with multiple organ failure successfully treated by plasma exchange and high-volume hemofiltration.
abstract: Background. Leptospirosis is a spirochetal zoonosis with complex clinical features including renal and liver failure. Case report. We report the case of a Swiss fisherman presenting with leptospirosis. After initial improvement, refractory septic shock and severe liver and kidney failure developed. The expected mortality was estimated at 90% with clinical scores. The patient underwent plasma exchanges and high-volume hemofiltration (HVHF) with complete recovery of hepatic and kidney functions. Discussion. Plasma exchanges and HVHF may confer survival benefit on patients with severe leptospirosis, refractory septic shock, and multiple-organ failure.
authors: Service de Néphrologie, Département de Médecine Interne, Hôpitaux Universitaires de Genève, 1205 Genève, Switzerland.
authors: Vincent
authors: V
authors: Bourquin
authors: Service de Néphrologie, Département de Médecine Interne, Hôpitaux Universitaires de Genève, 1205 Genève, Switzerland.
authors: Belén
authors: B
authors: Ponte
authors: Service des Maladies Infectieuses, Département de Médecine Interne, Hôpitaux Universitaires de Genève, 1205 Genève, Switzerland.
authors: Bernard
authors: B
authors: Hirschel
authors: Service des Soins Intensifs, Département d'Anesthésiologie, de Pharmacologie et des Soins Intensifs, Hôpitaux Universitaires de Genève, 1205 Genève, Switzerland.
authors: Jérôme
authors: J
authors: Pugin
authors: Service de Néphrologie, Département de Médecine Interne, Hôpitaux Universitaires de Genève, 1205 Genève, Switzerland.
authors: Pierre-Yves
authors: PY
authors: Martin
authors: Service de Néphrologie, Département de Médecine Interne, Hôpitaux Universitaires de Genève, 1205 Genève, Switzerland.
authors: Patrick
authors: P
authors: Saudan