A rare case of severe pneumonia caused by leptospirosis complicated with Jarisch-Herxheimer reaction.

BACKGROUND

Leptospirosis, a zoonotic disease caused by Leptospira species, presents significant diagnostic challenges due to its diverse clinical manifestations. Jarisch-Herxheimer reaction (JHR), an acute inflammatory response triggered by antibiotic therapy, can complicates disease management. Reports of leptospirosis with JHR remain rare, emphasizing the need for early diagnosis and appropriate treatment.

CASE PRESENTATION: An 80-year-old male presented with severe pneumonia, septic shock, and acute respiratory distress syndrome (ARDS). Diagnosis of leptospirosis was confirmed through metagenomic next-generation sequencing (mNGS) of bronchoalveolar lavage fluid, identifying Leptospira species. The patient was treated with piperacillin-tazobactam and supportive care, leading to full recovery.

CONCLUSIONS

This case highlights the importance of mNGS in diagnosing rare infections and the need for vigilance in managing JHR. Clinicians should consider leptospirosis in patients with unexplained severe pneumonia and systemic inflammation.