{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T03:03:19Z","timestamp":1779937399688,"version":"3.53.1"},"reference-count":6,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T00:00:00Z","timestamp":1777939200000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Respirology Case Reports"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Severe pulmonary leptospirosis (SPFL), characterized by diffuse alveolar haemorrhage (DAH) and acute respiratory distress syndrome (ARDS), carries a high mortality, often due to diagnostic delays and complex management. We report a case of a 42\u2010year\u2010old male with outdoor occupational exposure who presented with fever and hemoptysis, rapidly progressing to severe respiratory failure and thrombocytopenia. Chest imaging confirmed DAH\/ARDS. For refractory hypoxemia, veno\u2010venous extracorporeal membrane oxygenation (VV\u2010ECMO) was initiated without systemic anticoagulation due to active pulmonary haemorrhage. Metagenomic next\u2010generation sequencing (mNGS) of bronchoalveolar lavage fluid rapidly identified\n                    <jats:styled-content style=\"fixed-case\">\n                      <jats:italic>Leptospira interrogans<\/jats:italic>\n                    <\/jats:styled-content>\n                    , enabling targeted antimicrobial therapy alongside multidisciplinary support. The patient gradually improved, was successfully weaned from ECMO and ventilator support, and was discharged without residual organ dysfunction. This case demonstrates that early application of anticoagulation\u2010free VV\u2010ECMO combined with mNGS\u2010based rapid diagnosis and multidisciplinary care can improve outcomes in SPFL, highlighting the importance of considering this diagnosis in febrile patients with DAH and environmental exposure.\n                  <\/jats:p>","DOI":"10.1002\/rcr2.70565","type":"journal-article","created":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T00:50:02Z","timestamp":1778028602000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Extracorporeal Membrane Oxygenation Haemoperfusion for Leptospirosis Pulmonary Hemorrhagic Disease: Report of 1 Case"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-6146-9617","authenticated-orcid":false,"given":"Qigang","family":"Zeng","sequence":"first","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine Guangdong Hospital of Integrated Traditional Chinese and Western Medicine  Foshan Guangdong People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-7462-4330","authenticated-orcid":false,"given":"Longyun","family":"Xie","sequence":"additional","affiliation":[{"name":"Guangzhou University of Chinese Medicine  Guangzhou Guangdong People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenshan","family":"Dai","sequence":"additional","affiliation":[{"name":"Guangzhou University of Chinese Medicine  Guangzhou Guangdong People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feilong","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine Guangdong Hospital of Integrated Traditional Chinese and Western Medicine  Foshan Guangdong People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong","family":"Dai","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine Guangdong Hospital of Integrated Traditional Chinese and Western Medicine  Foshan Guangdong People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,5]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.7861\/clinmed.2021\u20100076"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.31128\/AFP\u201005\u201017\u20104204"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.4103\/0970\u20102113.102822"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.5005\/jp\u2010journals\u201010071\u201023852"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0000000000001230"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0249854"}],"container-title":["Respirology Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/rcr2.70565","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/rcr2.70565","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/rcr2.70565","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T02:29:07Z","timestamp":1779935347000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/rcr2.70565"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5]]},"references-count":6,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1002\/rcr2.70565"],"URL":"https:\/\/doi.org\/10.1002\/rcr2.70565","archive":["Portico"],"relation":{},"ISSN":["2051-3380","2051-3380"],"issn-type":[{"value":"2051-3380","type":"print"},{"value":"2051-3380","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5]]},"assertion":[{"value":"2026-02-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-12","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-05","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70565"}}