Journal of the Formosan Medical Association
Volume 106, Issue 2, Supplement , Pages S1-S6, 2007

Successful Treatment of Pulmonary Hemorrhage Associated with Leptospirosis and Scrub Typhus Coinfection by Early Plasma Exchange

  • Yun-Sung Chen

      Affiliations

    • Division of Pulmonary Medicine, Department of Internal Medicine, Far Eastern Memorial Hospital, Taipei, Taiwan
    • Division of Critical Care Medicine, Department of Internal Medicine, Far Eastern Memorial Hospital, Taipei, Taiwan
    • ,
  • Shih-Lung Cheng

      Affiliations

    • Division of Pulmonary Medicine, Department of Internal Medicine, Far Eastern Memorial Hospital, Taipei, Taiwan
    • ,
  • Hao-Chien Wang

      Affiliations

    • Division of Pulmonary Medicine, Department of Internal Medicine, Far Eastern Memorial Hospital, Taipei, Taiwan
    • Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
    • Corresponding Author InformationCorrespondence to: Dr Hao-Chien Wang Division of Pulmonary Medicine, Department of Internal Medicine, Far Eastern Memorial Hospital, 21, Section 2, Nanya South Road, Taipei 220, Taiwan
    • ,
  • Pan-Chyr Yang

      Affiliations

    • Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan

Received 7 December 2005; received in revised form 12 January 2006; accepted 7 March 2006.

Article Outline

Leptospirosis and scrub typhus coinfections have been reported in up to 41% of agricultural workers with acute leptospirosis in Thailand, but only sporadically in Taiwan. Because of the nonspecific clinical presentations, it is difficult to differentiate patients with coinfections from leptospirosis alone. However, failure to identify coinfection may lead to mortality if inappropriate antibiotics are used. We report a 31-year-old man coinfected with leptospirosis and scrub typhus, which manifested as diffuse alveolar hemorrhage and acute renal failure mimicking pulmonary-renal syndrome. The patient was treated by early plasma exchange and a 7-day course of moxifloxacin therapy. Both pulmonary hemorrhage and hypoxemia resolved substantially on the 4th day of hospitalization. He had a complete recovery from the disease after 6 weeks of hospitalization. [J Formos Med Assoc 2007;106(2 Suppl):S1-S6]

Key Words:  leptospirosis , moxifloxacin , plasma exchange , pulmonary hemorrhage , scrub typhus

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PII: S0929-6646(09)60344-2

doi:10.1016/S0929-6646(09)60344-2

Journal of the Formosan Medical Association
Volume 106, Issue 2, Supplement , Pages S1-S6, 2007

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