Pulmonary manifestation of leptospirosis

ABSTRACT

Authors analysed and present chest X-ray findings of serologically proven leptospirosis from Seoul NationalUniversity Hospital, either admitted or referred for serological verification, during recent 2 years. Radiologicalfindings were correlated with the lung specimen finding of experimentally induced leptospirosis in guinea pig. Theresults are as follows 1. 24 cases(56%) showed positive X-ray findings. 2. Predominent radiological patterns ofinvolved lung were tiny dot, small nodule, rosette density in 11 cases, massive confluent consolidation in 4cases, and diffuse ill-defined veilly increased density in 9 cases. 3. Distribution of pulmonary lesions werebilateral (100%), non-lobar, non-segmental(95%), and there were conspicuous tendency of peripheral lungpredominence. 4. Extrapulmonary manifestation, such as pleural effusion or cardiomegaly was rare. 5. Pulmonarylesions resolved completely usually 5 to 10 days after their appearance. 6. From the gross and microscopicfindings of serially sacrified guinea pig's lung and a case of autopsy, authors conlcuded that fine dot-likedensity in chest X-ray was due to petechial hemorrhage in intraalveolar space at initial stage, growing up toressette density or confluent consolidation as the petechia extends to surrounding lung forming purpura andcoalescent hemorrhage.