Contact may cause infection! If serious complications occur, the mortality rate is as high as 50%~70%

During the busy farming season some time ago, Mr. Fu (pseudonym), who was in his 60s, went to work in the fields as usual. However, he never expected that this trip would lead him to encounter an extremely terrible thing.

From having a fever to suddenly being on the verge of death , what happened?

After returning home that day, he felt cold and weak all over. When he took his temperature, he found out he had a fever. He went to the pharmacy and bought some medicine. After a few days, he did not feel better. Instead, he began to feel anxious, chest tightness, and shortness of breath .

His family hurriedly took him to a nearby hospital. By then, Mr. Fu had low blood pressure and blood in his sputum, so he was immediately transferred to a municipal hospital. His breathing became more and more rapid, and he even began to lose consciousness.

The situation was critical, and the doctor immediately intubated him and transferred him to the Run Run Shaw Hospital affiliated to Zhejiang University School of Medicine. At this time, he was already in a coma. After emergency examination, it was found that multiple organs in his body had failed and his condition was very serious. After emergency treatment, he was immediately admitted to the intensive care unit.

Why did the disease progress so rapidly? How did he suddenly become life-threatening? The doctor analyzed the disease from every possible point of view and finally found the culprit in his blood - Leptospira . CT scan revealed diffuse changes in both lungs (see Figure 1 below), and a large amount of bloody sputum was aspirated through bronchoscope. Mr. Fu was diagnosed with Leptospirosis, pulmonary hemorrhage type .

Leptospirosis of the pulmonary hemorrhage type is extremely dangerous, with a very high mortality rate. Fortunately, by adjusting the treatment plan in a targeted manner, he survived this stage, his condition improved, and the diffuse changes in both lungs in the follow-up CT scan also improved significantly (see Figure 2 below), and he was successfully transferred to the general ward.

Figure 1: Lung CT before treatment

Figure 2: Lung CT after treatment

Leptospirosis: Leptospirosis (abbreviated as leptospirosis) is caused by pathogenic spirochetes in the genus Leptospira, and is mainly transmitted to humans through broken skin, mucous membranes or conjunctivae .

The incidence rate is high during the rice harvest period , and farmers have a higher incidence rate

The main season for leptospirosis is during the rice harvest in summer and autumn (June to October), and the incidence rate among farmers is high. Carrying rodents, pigs and other animals are the main sources of infection . The excrement of these animals will contaminate rice fields and other environments. After people come into contact with contaminated water or environment, they can be infected through the skin and mucous membranes. Direct close contact with infected animals may also cause infection.

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Pulmonary hemorrhagic leptospirosis is less common, but the mortality rate is as high as 50% to 70%.

Most people have mild or no symptoms after infection. The acute phase generally lasts about 1 week and is characterized by the sudden onset of fever, chills, myalgia (especially in the calves and waist), and headache , which may also be accompanied by general fatigue and swollen lymph nodes.

However, some cases are severe and potentially fatal, and can progress rapidly and affect multiple systems, mainly including fever, jaundice, renal failure, pulmonary hemorrhage, shock and other serious manifestations. Pulmonary hemorrhage is a serious complication of leptospirosis, with symptoms including shortness of breath, cough and hemoptysis, seen in less than 5% of patients, but once infected, the reported mortality rate is as high as 50%~70%.

How to treat and prevent leptospirosis?

1 Treatment

Most leptospirosis infections are self-limiting. If you feel unwell, it is recommended to seek medical attention immediately. Antibiotics are effective in treating this disease.

2 Prevention

Human vaccines are not yet widely available. If individuals are likely to be exposed to leptospires in an endemic environment during a specific period of time, doxycycline can be used prophylactically.

In addition, it is necessary to actively control the sources of infection, especially rodents, and do a good job of extermination.

It is also recommended to develop good hygiene habits, such as washing hands frequently, and wearing long-sleeved clothes, long pants, and rain boots when doing farm work.
If there is skin damage, it is recommended to clean and disinfect the wound immediately.

In case of accidental exposure, such as being bitten by a rat, please seek medical attention immediately.

Planning and production

Source: Run Run Shaw Hospital

Editor: Yang Yaping