title: Anicteric leptospirosis with pneumonitis, pericarditis and acalculous cholecystitis.
abstract: We report the case of a 19-year-old male patient admitted to hospital with fever, asthenia, vomiting, abdominal and chest pains, cough with yellowish sputum, and hypotension. Laboratory tests showed leukocytosis and high creatine phosphokinase levels, without hyperbilirubinaemia or renal failure. The tomographic images of the chest and abdomen showed a right basal pneumonia and acalculous cholecystitis. The electrocardiograms revealed significant characteristics of acute pericarditis. Specific serology for leptospirosis done in the second and third weeks of disease showed positive results. The use of ceftriaxone 1g intravenously, twice a day for 7 days, resulted in an overall clinic improvement. The role of the suspicion index for diagnosis of leptospirosis is emphasized in anicteric patients, as well as the unsuspected possibility of pulmonary, pericardial and gallbladder involvement.
authors.affiliation: Medicine Department from Armed Forces Hospital; Catholic University of Brasilia, Brasil.
authors.forename: Vitorino Modesto dos
authors.initials: VM
authors.lastname: Santos
authors.affiliation: Medicine Department from Armed Forces Hospital; Catholic University of Brasilia, Brasil.
authors.forename: Uliana Medeiros dos
authors.initials: UM
authors.lastname: Santos
authors.affiliation: Medicine Department from Armed Forces Hospital; Catholic University of Brasilia, Brasil.
authors.forename: Daniela Gomes
authors.initials: DG
authors.lastname: Gebrin
authors.affiliation: Medicine Department from Armed Forces Hospital; Catholic University of Brasilia, Brasil.
authors.forename: Alessandra Maria Rodrigues Oliveira
authors.initials: AM
authors.lastname: Santos
authors.affiliation: Medicine Department from Armed Forces Hospital; Catholic University of Brasilia, Brasil.
authors.forename: Ana Carolina Vieira
authors.initials: AC
authors.lastname: Cancado
mesh_terms: D042101:Acalculous Cholecystitis / Q000382:microbiology*; D006801:Humans; D007922:Leptospirosis; D008297:Male; D010493:Pericarditis / Q000382:microbiology*; D018410:Pneumonia, Bacterial / Q000382:microbiology*; D055815:Young Adult