LEPTOSPIROSIS COMPLICATED BY A JARISCH-HERSHEIMER REACTION AND ADULT-RESPIRATORY-DISTRESS-SYNDROME - CASE-REPORT

Leptospirosis, severe infection due to Leptospira interrogans, is a po tentially lethal disease that causes multiple organ failure. In additi on to hepatic, renal. and CNS involvement, which are classic complicat ions of leptospirosis, the disease may also be complicated by adult re spiratory distress syndrome. Treatment with penicillin may precipitate a severe Jarisch-Herxheimer reaction. The mechanisms of leptospira-in duced toxicity remain obscure. We report a near-fatal case of leptospi rosis in a patient who developed a JHR and respiratory failure immedia tely after initiation of therapy.