A rapid turn for the worse: Steroid-responsive pulmonary haemorrhage in leptospirosis.
Kuljeet Singh, Vinay Venugopal, Kumar Puskar et al.
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Case in brief
A 43-year-old man presented with fever and cough, initially treated for community-acquired pneumonia. He rapidly deteriorated, developing type 1 respiratory failure. A history of exposure to waterlogged fields and declining blood parameters raised suspicion for leptospirosis, confirmed by positive IgM serology. He was treated with antibiotics and pulse methylprednisolone, leading to significant clinical improvement and successful weaning from noninvasive ventilation.
Diagnostic / clinical pearl
Clinicians should consider leptospirosis in patients with respiratory failure and a history of exposure to waterlogged environments, as early steroid therapy can significantly improve outcomes in severe cases.