Severe leptospirosis complicated with multiorgan dysfunction successfully managed with plasma exchange: a case report
Manana Dewage Sankani Vishvara Kularathna, Senanayake Abeysinghe Mudiyanselage Kularatne, Manoji Pathirage, Pala Thanthirige Madhushi Anuradha Nanayakkara
Abstract
BACKGROUND: Leptospirosis is a common zoonotic infection caused by the spirochete Leptospira. The disease is more prevalent in the tropics, causing subclinical to severe illness leading to high morbidity and mortality. CASE PRESENTATION: A 77-year-old healthy Sri Lankan man presented to the Teaching Hospital Peradeniya with severe leptospirosis complicated with acute kidney injury, pulmonary hemorrhages, myocarditis, and severe thrombocytopenia. He was deteriorating despite treatment with intravenous antibiotics and methylprednisolone boluses. He made a dramatic improvement with two cycles of plasma exchange. CONCLUSION: Therapeutic plasma exchange is a life-saving treatment modality in severe leptospirosis with multiorgan failure.