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
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Article info
Publication history
Published online: April 21, 2023
Accepted:
April 15,
2023
Received in revised form:
March 16,
2023
Received:
February 1,
2023
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
