TY - JOUR T1 - Weil’s disease with haemoptysis and acute respiratory distress syndrome JF - BMJ Case Reports JO - BMJ Case Reports DO - 10.1136/bcr-2019-229350 VL - 12 IS - 5 SP - e229350 AU - Afroditi Roumpou AU - Ioanna Papaioannou AU - Christos Lampropoulos Y1 - 2019/05/01 UR - http://casereports.bmj.com/content/12/5/e229350.abstract N2 - A 35-year-old male patient reached the emergency department after an episode of massive haemoptysis a few hours ago. Fever and dyspnea were mentioned to be present the last 5 days. His medical history included only malaria, successfully treated 2 years ago. Clinical examination revealed high fever, jaundice, cyanosis, tachypnea and bilateral rales on pulmonary auscultation. Laboratory investigation showed high erythrocyte sedimentation rate and C reactive protein, leucocytosis, anaemia, mild thrombocytopaenia, renal impairment, hyperbilirubinaemia and abnormal liver function tests; arterial blood gas analysis showed respiratory alkalosis with severe hypoxia. Thoracic X-ray revealed bilateral pulmonary infiltrates, whereas abdominal and heart ultrasound detected hepatomegaly and small pericardial infusion, respectively. The diagnosis of leptospirosis along with acute respiratory distress syndrome was confirmed by positive IgM Leptospira antibodies. Empirical treatment with triple antibiotic therapy and corticosteroids was applied. The patient was discharged after 1 week, without any symptoms and with almost normal laboratory tests. ER -