Author/Editor		Sinkovič, Andeja; Hojs, Radovan; Veble, Andrej; Baklan, Zvonko
Title		Težka oblika leptospiroze z akutnim pankreatitisom in večorgansko odpovedjo - prikaz primera in pregled literature
Translated title		Severe leptospirosis with acute pancreatitis and multiorgan failure syndrome - case report and an overview of the literature
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 65, št. 2
Publication year		1996
Volume		str. 71-3
Language		slo
Abstract		Background. Only about 10 percent of cases of leptospirosis, world's most widespread zoonosis, represent a severe systemic illness with acute renal and respiratory failure, jaundice, hemorrhages, cardiac, pancreatic and neurologic involvement and mortality rate up to 50 percent. Methods and results. We describe a case of a 41 years old male from rural and endemic area for leptospirosis, who was admitted to the hospital because of fever, abdominal pain, jaundice and vomiting and treated by pefloxacin and intravenous fluids because of suspected acute pancreatitis with acalculous cholecystitis. After the obstruction of the bile ducts was excluded and epidemiologic data were revaluated the suspect of leptospirosis was raised and finally confirmed by a serologic test. Although he was treated by antibiotics, intravenous fluids, hemodialysis and mechanically ventilated, the patient developed multiorgan failure syndrome and died of heart failure. Conclusions. Because the early treatment of leptospirosis is important, our clinical observation suggests, that in an endemic area leptospirosis should be considered as a potential cause of an acute pancreatitis.
Summary		Izhodišča. Le 10 odstotkov primerov leptospiroze, v svetu najbolj razširjene zoonoze, predstavlja težko sistemsko bolezen z akutno ledvično in respiracijsko odpovedjo, zlatenico, krvavitvami, prizadetostjo srca in trebušne slinavke, nevrološkimi izpadi in smrtnostjo do 50 odstotkov. Metode in rezultati. Avtorji opisujejo primer 41-letnega bolnika iz kmečkega in endemskega področja za leptospirozo, ki je bil sprejet v bolnišnico zaradi vročine, bolečin v trebuhu, zlatenice in bruhanja ter je bil zdravljen s kinolonom pefloksacinom in infuzijami tekočin zaradi suma na akutni pankreatitis z akalkuloznim holecistitisom. Po izključitvi zapore žolčevodov in ponovnem preverjanju epidemioloških podatkov je bil postavljen sum na leptospirozo, ki je bila dokazana s serološkim testom. Kljub zdravljenju z antibiotiki, infuzijami tekočin, mehanični ventilaciji in hemodializi je bolezen napredovala v večorgansko odpoved in smrtno končala zaradi odpovedi srca. Zaključki. Ker je zgodnje zdravljenje leptospiroze pomembno, bi bilo treba to bolezen upoštevati kot možni vzrok akutnega pankreatitisa, posebno v endemskih krajih.
Descriptors		LEPTOSPIROSIS PANCREATITIS MULTIPLE ORGAN FAILURE