AI Summary & Key Takeaways
AI InsightWhen the patient's history was further investigated; it was found that his contact with sewage water twelve days ago before his complaint so this lead us to think that the leptospirosis was preliminary diagnosis.
📌 3 Key Takeaways
Abstract
66 years old man; was addmitted to emergency room with high fever, headache, confusion; generalized muscle pain; nausea, vomiting; yellowish discoloration of skin and eyes. 3-4 days before emergency room admission; complaint of fever, headache, chilling was started suddenly. On physical examination; bilateral subkonjonktival hemorrage and conjunctivitis; coldness and mild cyanosis of all-over four extremities was found. His skin and scleras were obviously icteric and he was in semiconscious state and his general appearance was poor. Laboratory evaluation showed predimonant thrombocytopenia; elevated BUN and creatinine levels; increased liver enzymes, total and direct bilirubin; and also certainly elevated CPK. On urine analysis there was proteinuria, hematuria and pyuria. When the patient's history was further investigated; it was found that his contact with sewage water twelve days ago before his complaint so this lead us to think that the leptospirosis was preliminary diagnosis. Leptospirosis is an infectious disease caused by pathojenic leptospiros varies from inapparent illness to fatal disease.
Özet
Altmışaltı yaşında erkek hasta; ateş yüksekliği, baş ağrısı, şuur bulanıklığı, yaygın kas ağrısı, bulantı kusma, gözlerinde ve vücudunda sararma şikayetleri ile acile getirildi. 3-4 gün önce ani başlayan baş ağrısı, titreme ve ateş şikayeti olmuş. Fizik muayenede genel durumu kötü, şuuru konfuze idi. Cilt ve skleralar ikterik, bilateral konjunktival kanama ve konjonktiviti vardı. Her dört ekstremite soğuk ve hafif siyanoze idi. Labaratuvar tetkiklerinde belirgin trombositopeni, BUN -kreatinin yüksekliği, total ve direkt bilirubin yüksekliği, karaciğer enzim yüksekliğinin yanısıra belirgin kreatin fosfakinaz (CPK) yüksekliği, tam idrar analizinde proteinüri, hematüri, piyüri saptandı. Hastanın anemnezinde 12 gün önce kanalizasyon suyu ile temasının olması üzerine ön tanı olarak leptospirozis düşünüldü. Leptospirozis, patojenik leptospiraların neden olduğu hafif enfeksiyon tablosuyla seyredebildiği gibi, fulminan hatta fatal seyredebilen