Multiple Pulmonary Nodules in Leptospirosis

Abstract

A 21-year-old man presented with the chief complaints of fever and sore throat after visiting Cambodia and Thailand. Computed tomography revealed multiple pulmonary nodules. After performing antibiotic therapy, the pulmonary nodules without bacteremia disappeared completely. Paired microscopic agglutination tests revealed seroconversion against Leptospira serogroup Autumnalis. Thus, he was diagnosed with multiple pulmonary nodules caused by leptospirosis. Leptospirosis is a common zoonosis that occurs in tropical and subtropical areas. Its various clinical features include unspecified fever and Weil's disease. Although diffuse alveolar hemorrhaging is known to occur in severe leptospirosis, multiple pulmonary nodules resembling septic emboli or vasculitis are a rare complication.

Misdiagnosis of pneumorrhagia leptospirosis as common CAP: A case report and literature review

“…Chest radiographs may show small nodules that can progress to consolidation or ground-glass opacities. Pathologically, this can represent alveolar hemorrhage, acute respiratory distress syndrome (ARDS), or pulmonary edema [ 25 , 26 ]. As bleeding increases, small punctate shadows can fuse and enlarge, forming patchy and even plaque shadows with blurred edges.…”