{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T18:56:37Z","timestamp":1781204197107,"version":"3.54.1"},"reference-count":14,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T00:00:00Z","timestamp":1638316800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,12,13]],"date-time":"2021-12-13T00:00:00Z","timestamp":1639353600000},"content-version":"vor","delay-in-days":12,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Med Case Reports"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Leptospirosis is a common zoonotic infection caused by the spirochete <jats:italic>Leptospira<\/jats:italic>. The disease is more prevalent in the tropics, causing subclinical to severe illness leading to high morbidity and mortality.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>A 77-year-old healthy Sri Lankan man presented to the Teaching Hospital Peradeniya with severe leptospirosis complicated with acute kidney injury, pulmonary hemorrhages, myocarditis, and severe thrombocytopenia. He was deteriorating despite treatment with intravenous antibiotics and methylprednisolone boluses. He made a dramatic improvement with two cycles of plasma exchange.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Therapeutic plasma exchange is a life-saving treatment modality in severe leptospirosis with multiorgan failure.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13256-021-03135-3","type":"journal-article","created":{"date-parts":[[2021,12,13]],"date-time":"2021-12-13T10:05:44Z","timestamp":1639389944000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Severe leptospirosis complicated with multiorgan dysfunction successfully managed with plasma exchange: a case report"],"prefix":"10.1186","volume":"15","author":[{"given":"Manana Dewage Sankani Vishvara","family":"Kularathna","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Senanayake Abeysinghe Mudiyanselage","family":"Kularatne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manoji","family":"Pathirage","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pala Thanthirige Madhushi Anuradha","family":"Nanayakkara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,12,13]]},"reference":[{"key":"3135_CR1","unstructured":"Dutta TK, Christopher M. Leptospirosis\u2014an overview. 2005;53(June)."},{"key":"3135_CR2","unstructured":"Sheet F. Leptospirosis."},{"key":"3135_CR3","doi-asserted-by":"publisher","unstructured":"Oludele J, Lesko B, Mahumane Gundane I, de Bruycker-Nogueira F, Muianga A, Ali S, Mula F, Chelene I, Falk KI, Barreto Dos Santos FGE. National guidelines on management of leptospirosis. Vol. 5; 2017. https:\/\/doi.org\/10.4269\/ajtmh.17-0317","DOI":"10.4269\/ajtmh.17-0317"},{"key":"3135_CR4","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-662-45059-8_5","author":"DA Haake","year":"2015","unstructured":"Haake DA, Levett PN. Leptospirosis in humans. Curr Top Microbiol Immunol. 2015. https:\/\/doi.org\/10.1007\/978-3-662-45059-8_5.","journal-title":"Curr Top Microbiol Immunol"},{"key":"3135_CR5","first-page":"429","volume":"131","author":"SV Trivedi","year":"2010","unstructured":"Trivedi SV, Vasava AH, Bhatia LC, Patel TC, Patel NK, Patel NT. Plasma exchange with immunosuppression in pulmonary alveolar haemorrhage due to leptospirosis. Indian J Med Res. 2010;131:429\u201333.","journal-title":"Indian J Med Res"},{"key":"3135_CR6","first-page":"iii","volume-title":"Human leptospirosis: guidance for diagnosis, surveillance and control","author":"WHO","year":"2003","unstructured":"WHO. Human leptospirosis: guidance for diagnosis, surveillance and control. Geneva: World Health Organization; 2003. p. iii."},{"key":"3135_CR7","doi-asserted-by":"publisher","DOI":"10.1590\/S1678-9946201860023","author":"T De Brito","year":"2018","unstructured":"De Brito T, da Silva AMG, Abreu PAE. Pathology and pathogenesis of human leptospirosis: a commented review. Rev Inst Med Trop Sao Paulo. 2018. https:\/\/doi.org\/10.1590\/S1678-9946201860023.","journal-title":"Rev Inst Med Trop Sao Paulo"},{"key":"3135_CR8","doi-asserted-by":"publisher","DOI":"10.1136\/pgmj.2009.092734","author":"SAM Kularatne","year":"2011","unstructured":"Kularatne SAM, Budagoda BDSS, De Alwis VKD, et\u00a0al. High efficacy of bolus methylprednisolone in severe leptospirosis: a descriptive study in Sri Lanka. Postgrad Med J. 2011. https:\/\/doi.org\/10.1136\/pgmj.2009.092734.","journal-title":"Postgrad Med J"},{"key":"3135_CR9","doi-asserted-by":"publisher","DOI":"10.1093\/trstmh\/tru148","author":"TR Soc","year":"2014","unstructured":"Soc TR, Med T, Rodrigo C, et\u00a0al. High dose corticosteroids in severe leptospirosis: a systematic review. Trans R Soc Trop Med Hyg. 2014. https:\/\/doi.org\/10.1093\/trstmh\/tru148.","journal-title":"Trans R Soc Trop Med Hyg"},{"key":"3135_CR10","doi-asserted-by":"publisher","DOI":"10.1155\/2011\/817414","author":"V Bourquin","year":"2011","unstructured":"Bourquin V, Ponte B, Hirschel B, Pugin J, Martin P-Y, Saudan P. Severe leptospirosis with multiple organ failure successfully treated by plasma exchange and high-volume hemofiltration. Case Rep Nephrol. 2011. https:\/\/doi.org\/10.1155\/2011\/817414.","journal-title":"Case Rep Nephrol"},{"issue":"1","key":"3135_CR11","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/1752-1947-7-169","volume":"7","author":"C Reports","year":"2013","unstructured":"Reports C, Taylor D, Karamadoukis L. Plasma exchange in severe leptospirosis with multiorgan failure: a case report. J Med Case Rep. 2013;7(1):1. https:\/\/doi.org\/10.1186\/1752-1947-7-169.","journal-title":"J Med Case Rep"},{"key":"3135_CR12","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1016\/j.transci.2011.07.012","volume":"45","author":"C Cerdas-quesada","year":"2011","unstructured":"Cerdas-quesada C. Potential benefits of plasma exchange by apheresis on the treatment of severe icteric leptospirosis: case report and literature review q. Transfus Apheresis Sci. 2011;45:191\u20134. https:\/\/doi.org\/10.1016\/j.transci.2011.07.012.","journal-title":"Transfus Apheresis Sci"},{"key":"3135_CR13","first-page":"482","volume":"9","author":"T KaiChung","year":"2002","unstructured":"KaiChung T, PokSiu Y, KingMen H, et\u00a0al. Potential benefit of plasma exchange in treatment of severe icteric leptospirosis complicated by acute renal failure. Clin Diagn Lab Immunol. 2002;9:482\u20134.","journal-title":"Clin Diagn Lab Immunol"},{"key":"3135_CR14","doi-asserted-by":"publisher","DOI":"10.1155\/2018\/4520185","author":"CL Fonseka","year":"2018","unstructured":"Fonseka CL, Lekamwasam S. Role of plasmapheresis and extracorporeal membrane oxygenation in the treatment of leptospirosis complicated with pulmonary hemorrhages. J Trop Med. 2018. https:\/\/doi.org\/10.1155\/2018\/4520185.","journal-title":"J Trop Med"}],"container-title":["Journal of Medical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13256-021-03135-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13256-021-03135-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13256-021-03135-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,13]],"date-time":"2021-12-13T10:13:39Z","timestamp":1639390419000},"score":1,"resource":{"primary":{"URL":"https:\/\/jmedicalcasereports.biomedcentral.com\/articles\/10.1186\/s13256-021-03135-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12]]},"references-count":14,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["3135"],"URL":"https:\/\/doi.org\/10.1186\/s13256-021-03135-3","relation":{},"ISSN":["1752-1947"],"issn-type":[{"value":"1752-1947","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12]]},"assertion":[{"value":"19 August 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 September 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 December 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of written consent is available for review by the Editor-in-Chief of this journal.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for data collection and publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"584"}}