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Link to original content: http://pubmed.ncbi.nlm.nih.gov/37075979/
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Case Reports
. 2023 Aug;29(8):800-802.
doi: 10.1016/j.jiac.2023.04.009. Epub 2023 Apr 17.

Report of Weil's disease with a fatal course triggered by Jarisch-Herxheimer reaction

Yuki Chiko  1 , Kinue Shiokawa  2 , Ikumi Namihira  2 , Kensuke Itagaki  2 , Kengo Maruyama  2 , Yuki Tachibana  2 , Yoshinori Ryu  2 , Tatsuya Sakai  2
Affiliations
Case Reports

Report of Weil's disease with a fatal course triggered by Jarisch-Herxheimer reaction

Yuki Chiko et al. J Infect Chemother. 2023 Aug.

Abstract

Leptospirosis, a zoonotic disease characterized by a spectrum of influenza-like symptoms, can manifest as severe cases so called Weil's disease. Early diagnosis and treatment are crucial to avoid the potentially fatal course of the disease. Within 24 hours of the initial administration of antibiotics, patients may experience the Jarisch-Herxheimer reaction (JHR), characterized by chills, fever, hypotension, and impaired consciousness. The Okinawa Prefecture, where our hospital is situated, boasts the highest incidence rate of leptospirosis among all regions in Japan. This reports our encounter with the initial leptospirosis case after a period of 16 years within the Okinawa Prefecture. This case exhibited JHR and required the utilization of noradrenaline (NA). Despite evidence indicating that JHR does not correlate with mortality, we contend that diagnosis of Weil's disease necessitates admission to an intensive care unit (ICU) and vigilant monitoring for JHR, as it may result in impairment of general condition and fatal outcome, as observed in our case.

Keywords: Jarisch-Herxheimer reaction; Leptospirosis; Neglected tropical disease; Weil's disease.

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Conflict of interest statement

Declaration of competing interest The authors state that they have no Conflict of Interest.

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