1973 Volume 47 Issue 10 Pages 393-399
A 17-year-old Japanese cook was admitted to Nakano General Hospital with nose bleeding, fever, jaundice and myalgia of several days duration. Diagnosis of “Weil's disease” was made clinically and serologically. Antibody titer of “Leptospira icterohaemorrhagiae” was found to be elevated to 320 times higher than control.
No spirochaeta was found in the patient's urine nor in the blood.
Streptomycin, steroid, and intravenous fluid infusion lessened the hemorrhagic tendency and jaundice. The patient, however, became agitated and made any further treatment impossible, such as hemodialysis to remove excessive blood urea and bilirubin. Sedation and tranquillization were not done in consideration of hepatic dysfunction. On the 25th day of the disease, he was expired after the abrupt onset of shock.
The postmortem examination revealed a massive bleeding from a duodenal ulcer, and edema with jaundice of almost all the organs.
The case was evaluated in comparison with 84 reported autopsied cases in Japan.
