Massive pulmonary haemorrhage caused by leptospirosis successfully treatedwith nitric oxide inhalation and haemofiltration

A patient with leptospirosis who developed oliguric renal failure, massive pulmonary haemorrhage and respiratory failure is described, The patient's c linical condition and arterial oxygenation failed to improve despite vigoro us supportive measures. Nitric oxide inhalation and haemofiltration resulte d in a marked clinical improvement and subsequent full recovery. We suggest that the addition of haemofiltration and nitric oxide inhalation therapy s hould be considered in patients with pulmonary haemorrhage and renal failur e caused by leptospirosis, in whom conventional therapy fails.