Indian Journal of Critical Care Medicine

Register      Login



Volume / Issue

Online First

Related articles

VOLUME 26 , ISSUE 8 ( August, 2022 ) > List of Articles


Extracorporeal Membrane Oxygenation in Severe Pulmonary Forms of Leptospirosis: A Report of Two Cases

Suvadeep Sen, Vaishali Lokhande

Keywords : Acute respiratory distress syndrome, Extracorporeal membrane oxygenation, Leptospirosis, Tropical infections

Citation Information : Sen S, Lokhande V. Extracorporeal Membrane Oxygenation in Severe Pulmonary Forms of Leptospirosis: A Report of Two Cases. Indian J Crit Care Med 2022; 26 (8):966-969.

DOI: 10.5005/jp-journals-10071-24286

License: CC BY-NC 4.0

Published Online: 30-07-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Pulmonary involvement in leptospirosis is common. Severe pulmonary forms of leptospirosis (SPFL) carry high mortality. We report two cases of an otherwise healthy adult male from the western suburbs of India, admitted with severe pulmonary hemorrhage with extremely poor oxygenation. Veno-venous extracorporeal membrane oxygenation (VV-ECMO) was used as the last-rescue life-saving measure. Both the patients showed good pulmonary recovery within 2 weeks. Despite having thrombocytopenia, we experienced lesser bleeding complications requiring transfusions during the extracorporeal membrane oxygenation (ECMO) period.

PDF Share
  1. Arokianathan D, Trower K, Pooboni S, Sosnowski A, Moss P, Thaker H. Leptospirosis: a case report of a patient with pulmonary haemorrhage successfully managed with extra corporeal membrane oxygenation. J Infect 2005;50(2):158–162. DOI: 10.1016/j.jinf.2004.09.010.
  2. Umei N, Ichiba S. A case of leptospirosis-associated severe pulmonary hemorrhagic syndrome successfully treated with venovenous extracorporeal membrane oxygenation. Case Rep Crit Care 2017; 2017:5369267. DOI: 10.1155/2017/5369267.
  3. Roberto C, Carvalho R, Bethlem EP. Pulmonary complications of leptospirosis. Clinics in Chest Medicine 2002;23(2):469–478. DOI: 10.1016/S0272-5231(01)00010-7.
  4. Extracorporeal Life Support Organization (ELSO) Guidelines for Adult Respiratory Failure. Extracorporeal Life Support Organization; 2017.
  5. Agerstrand CL, Burkart KM, Abrams DC, Bacchetta MD, Brodie D. Blood conservation in extracorporeal membrane oxygenation for acute respiratory distress syndrome. Ann Thorac Surg 2015;99(2): 590–595. DOI: 10.1016/j.athoracsur.2014.08.039.
  6. Pardinas M, Mendirichaga R, Budhrani G, Garg R, Rosario L, Rico R, et al. Use of aminocaproic acid in combination with extracorporeal membrane oxygenation in a case of leptospirosis pulmonary hemorrhage syndrome. Clin Med Insights: Circ, Respir Pulm Med 2017;11. DOI: 10.1177/1179548416686068.
  7. Cantwell T, Ferre A, Van Sint Jan N, Blamey R, Dreyse J, Baeza C, et al. Leptospirosis-associated catastrophic respiratory failure supported by extracorporeal membrane oxygenation. J Artif Organs 2017;20(4):371–376. DOI: 10.1007/s10047-017-0998-x.
  8. Ludwig B, Zotzmann V, Bode C, Staudacher DL, Zschiedrich S. Lethal pulmonary hemorrhage syndrome due to Leptospira infection transmitted by pet rat. IDCases 2017;8:84–86. DOI: 10.1016/j.idcr.2017.04.016.
  9. Chavez JR, Danguilan RA, Arakama MI, Garcia JKG, So R, Chua E. A case of leptospirosis with acute respiratory failure and acute kidney injury treated with simultaneous extracorporeal membrane oxygenation and haemoperfusion. BMJ Case Rep 2019;12(5): e229582. DOI: 10.1136/bcr-2019-229582.
  10. Chaikajornwat J, Rattanajiajaroen P, Srisawat N, Kawkitinarong K. Leptospirosis manifested with severe pulmonary haemorrhagic syndrome successfully treated with venovenous extracorporeal membrane oxygenation. BMJ Case Rep 2020;13(1):e230075. DOI: 10.1136/bcr-2019-230075.
  11. Delmas B, Jabot J, Chanareille P, Ferdynus C, Allyn J, Allou N, et al. Leptospirosis in ICU: a retrospective study of 134 consecutive admissions. Crit Care Med 2018;46(1):93–99. DOI: 10.1097/CCM.0000000000002825.
  12. Liao CY, Ben RJ, Wu HM, Chang SK, Liu MY, Chin HK, et al. Acute respiratory distress syndrome manifested by leptospirosis successfully treated by extracorporeal membrane oxygenation (ECMO). Intern Med 2015;54(22):2943–2946. DOI: 10.2169/internalmedicine.54.4528.
  13. Héry G, Letheulle J, Flécher E, Quentin C, Piau C, Le Tulzo Y, et al. Massive intra-alveolar hemorrhage caused by Leptospira serovar Djasiman in a traveler returning from Laos. J Travel Med 2015;22(3):212–214. DOI: 10.1111/jtm.12189.
  14. Kahn JM, Müller HM, Kulier A, Keusch-Preininger A, Tscheliessnigg K-H. Veno-arterial extracorporeal membrane oxygenation in acute respiratory distress syndrome caused by leptospire sepsis. Anesth Analg 2006;102(5):1597–1598. DOI: 10.1213/01.ANE.0000215121.67833.2F.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.