Jose Maria-Rios is an Emergency Medicine Resident at the University of Puerto Rico School of Medicine. Gerald Marin-Garcia is a Staff Physician in Emergency and Critical Care Medicine and William Rodriguez-Cintron is a Pulmonary and Critical Care Medicine Division Chief and Program Director, both at the VA Caribbean Healthcare System; all in San Juan, Puerto Rico. Correspondence: William Rodriguez-Cintron (william.rodriguez@va.gov)
Author disclosures The authors report no actual or potential conflicts of interest with regard to this article.
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LS continues to be of interest due to its current status as the most common zoonotic disease and its widespread prevalence throughout the globe. Novel treatment modalities for LS, specifically for Weil disease, continue to be developed with the goal of reducing the current mortality rate associated with the disease.
In endemic areas, prompt recognition is essential to initiate the recommended therapy. Parenteral antibiotics, such as penicillin G sodium and ceftriaxone, continue to be the mainstay of treatment and constitute the current CDC recommendations. Nonetheless, early initiation of CRRT has been shown to greatly reduce the mortality associated with Weil disease and, when available, should be considered in these patients.
Our patient failed to improve while receiving parenteral antibiotics alone but showed marked improvement after being placed on CRRT. Furthermore, initiation of CRRT resulted in near-complete resolution of his organ dysfunction and eventual discharge from the hospital. This case serves to further support the use of early CRRT as part of the standard of care in severe LS.
