| Abstract: | Leptospirosis (Weil-Vasiliev disease) is a zoonotic natural focal disease running as an acute fever with severe intoxication, lesion of the kidneys, liver, CNS, hemorrhagic syndrome, complications, frequent lethal outcomes. Clinical features of leptospirosis in patients with comorbid diseases are not studied adequately. Lethal outcomes are often caused by such serious complications as infectious-toxic shock, acute renal-hepatic failure, massive hemorrhagic syndrome, infectious myocarditis, etc. Two cases of leptospirosis with irreversible complications are reported: one case with severe lesion of the kidneys and heart, and the other case with lethal damage to the kidneys. The evidence for a severe course of leptospirosis complicated with renal insufficiency is provided. Lethal outcomes in leptospirosis are often associated with late diagnosis because of the disease manifestation similarity with such diseases as hemorrhagic fever and renal syndrome. It is shown that leptospirosis runs a very severe cause in exacerbation of preexisting infection or somatic disease. The necessity of consideration of the background pathology demands an early and individual correction of diagnostic algorithms, conduction of etiotropic and pathogenetic therapy, rehabilitation measures. Comorbid diseases in leptospirosis patients have an essential negative effect on leptospirosis clinical picture, on a course of infectious process (aggravation of endogenic intoxication, polyorganic disorders, nonspecific complications). |
