Year 2023 / Volume 115 / Number 8
Letter
Weil syndrome coincident with upper gastrointestinal bleeding

458-459

DOI: 10.17235/reed.2022.9086/2022

Claudia Barber Caselles, Jesus Manuel Rivera Esteban, Alessandro Avonello Maynard, Fernando Salvador, Carmen Alonso Cotoner,

Abstract
A 48 year old male was referred to our center due to a gastrointestinal bleeding with melena secondary to a Forrest IIb gastric ulcer treated endoscopically. Physical examination revealed bilateral conjunctival suffusion, bradypsychia, and asterixis. Epidemiological history included a trip to Dominican Republic two weeks before, presenting later a flu-like syndrome. He had no history of NSAID use. Laboratory tests showed a normocytic anemia, leukocytosis with neutrophilia, acute renal failure, severe hyponatremia, a predominant direct hyperbilirubinemia, hyperamylasemia, and mild coagulopathy (Table 1). An abdominal ultrasound was performed, with no pathological findings, and a chest-abdominal computed tomography (CT), bilateral diffuse ground glass pulmonary opacities and pleural effusion, mild hepatomegaly, and peritoneal and gastrohepatic ligament lymphadenopathy, with no signs of acute pancreatitis. A second look upper endoscopy revealed a Forrest III gastric ulcer. Gastric biopsies results ruled out malignancy and Helicobacter pylori infection. Due to his recent travel history combined with his characteristic signs and symptoms a clinical diagnosis of leptospirosis was made and empirical antibiotic therapy with meropenem was started. The serology for Leptospira was positive (IgG 1/1600) and antibiotic therapy was de-escalated to ceftriaxone with clinical and analytical remission on day five of his hospital stay with complete radiological resolution at 6 months.
Share Button
New comment
Comments
No comments for this article
References
1. Pothuri.P. et al. Leptospirosis Presenting with Radidly Progressing Acute Renal Failure and Conjugated Hyperbilirubinemia: A case Report. Am J Case Rep, 2016; 17:567-569.
2. Legris et al. Ameboma: an unusual cause of gastrointestinal bleeding during severe leptospirosis. BMC Infectious Diseases 2014, 14:299.
3. Alian Sh, Davoudi A, Najafi N, Ghasemian R, Ahangarkani F, Hamdi Z. Clinical and laboratory manifestation and outcome of icterohemorrhagic leptospirosis patients in Northern Iran. Med J Islam Repub Iran 2015 (15 December). Vol.29:308
4. Mwachui MA, Crump L, Hartskeerl R, Zinsstag J, Hattendorf J (2015). Environmental and Behavioural Determinants of Leptospirosis Transmission: A Systematic Review. PLOS Negle Trop Dis 9 (9): e0003843. doi:10.1371/journal.pntd.0003843.
5. Alventosa Mateu C, Plana Campos L, Larrey Ruíz L, Acedo Mayordomo R, Sanchís Artero L, Peño Muñoz L, et al. Hemorragia digestiva e insuficiencia hepática aguda por leptospirosis: una entidad que no debemos olvidar. Rev Gastroenterol Peru. 2017;37(1):96-9.
Related articles

Letter

Jejunal gastrointestinal stromal tumor: a diagnostic challenge

DOI: 10.17235/reed.2024.10108/2023

Letter

Blue rubber bleb nevus syndrome

DOI: 10.17235/reed.2023.9913/2023

Letter

Upper gastrointestinal bleeding and Rigler triad

DOI: 10.17235/reed.2023.9731/2023

Digestive Diseases Image

Germ cell tumor with duodenal involvement: a rare case of gastrointestinal bleeding

DOI: 10.17235/reed.2022.9327/2022

Letter

A rare cause of obscure gastrointestinal bleeding

DOI: 10.17235/reed.2022.9156/2022

Letter

A full hemostatic repertoire in a complex cirrhotic patient

DOI: 10.17235/reed.2022.9039/2022

Letter

Hemostasis of a bleeding inverted colonic diverticulum

DOI: 10.17235/reed.2022.9019/2022

Letter

Primary intestinal melanoma?

DOI: 10.17235/reed.2022.8944/2022

Letter

A rare cause of a bulging mass in the mid esophagus

DOI: 10.17235/reed.2022.8834/2022

Digestive Diseases Image

Ileal neuroendocrine tumor as an uncommon cause of obscure gastrointestinal bleeding

DOI: 10.17235/reed.2022.8641/2022

Digestive Diseases Image

Bezoar: an uncommon cause of upper gastrointestinal bleeding

DOI: 10.17235/reed.2021.8311/2021

Letter

COVID-19 and aorto-enteric fistula

DOI: 10.17235/reed.2021.8272/2021

Digestive Diseases Image

Ink stained gastric lesions: a rare cause of gastrointestinal bleeding

DOI: 10.17235/reed.2021.8141/2021

Digestive Diseases Image

Gastric plasmacytoma: a rare cause of upper gastrointestinal bleeding

DOI: 10.17235/reed.2021.7816/2021

Letter to the Editor

Severe obscure gastrointestinal bleeding successfully treated with idarucizumab

DOI: 10.17235/reed.2018.5298/2017

Letter to the Editor

Gangliocytic paraganglioma: an unusual cause of upper gastrointestinal bleeding

DOI: 10.17235/reed.2017.4808/2016

Letter to the Editor

Gastric neuroendocrine tumor presenting with gastrointestinal bleeding

DOI: 10.17235/reed.2015.3998/2015

Case Report

Downhill varices: an uncommon cause of upper gastrointestinal bleeding

DOI: 10.17235/reed.2015.3697/2015

Citation tools
Barber Caselles C, Rivera Esteban J, Maynard A, Salvador F, Alonso Cotoner C. Weil syndrome coincident with upper gastrointestinal bleeding. 9086/2022


Download to a citation manager

Download the citation for this article by clicking on one of the following citation managers:

Metrics
This article has received 1291 visits.
This article has been downloaded 106 times.

Statistics from Dimensions


Statistics from Plum Analytics

Publication history

Received: 17/07/2022

Accepted: 26/09/2022

Online First: 20/10/2022

Published: 26/07/2023

Article Online First time: 95 days

Article editing time: 374 days


Share
This article hasn't been rated yet.
Reader rating:
Valora este artículo:




Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
The Spanish Journal of Gastroenterology is the official organ of the Sociedad Española de Patología Digestiva, the Sociedad Española de Endoscopia Digestiva and the Asociación Española de Ecografía Digestiva
Cookie policy Privacy Policy Legal Notice © Copyright 2023 y Creative Commons. The Spanish Journal of Gastroenterology