Weil’s syndrome: from various organic dysfunctions to a favorable outcome

Authors

  • Luana Vasconcelos Freitas Instituto de Infectologia Emílio Ribas, Infectologia - São Paulo - SP - Brasil.
  • Zita Maria Leme Britto Instituto de Infectologia Emílio Ribas, Nefrologia - São Paulo - SP - Brasil.
  • Aline Borges Moreira Rocha Instituto de Infectologia Emílio Ribas, Infectologia - São Paulo - SP - Brasil.
  • Bruno Correira Ernandes Instituto de Infectologia Emílio Ribas, Infectologia - São Paulo - SP - Brasil.

DOI:

https://doi.org/10.5935/2764-734X.e20240438

Keywords:

Leptospirosis, Weil Disease, Acute Kidney Injury, Renal Dialysis, Case report

Abstract

Human leptospirosis is the most widely distributed zoonosis globally. In tropical countries, it is an endemic disease, and outbreaks coincide with rainy periods, especially in flooded areas. In its early stages, early recognition of leptospirosis is challenged by the nonspecific signs and symptoms, making it necessary to value related epidemiological data to consider this diagnostic hypothesis, and subsequently, prescribe effective antimicrobial treatment from the beginning. Evolution of leptospirosis to a second stage with pulmonary, hepatic, and renal dysfunction determines a more serious and less frequent form of the disease, known as Weil’s syndrome. Herein, we describe a classic case of Weil’s syndrome, whose early recognition and appropriate treatment led to a satisfactory clinical response and total recovery, despite the initial severity of the condition.

References

1. Gilden D, Cohrs RJ, Mahalingam R, Nagel MA. Varicella zoster virus vasculopathies: diverse clinical manifestations, laboratory features, pathogenesis, and treatment. Lancet Neurol. 2009;8(8):731-40. DOI: 10.1016/S1474-4422(09)70134-6

2. Marra CM. Infectious and postinfectious vasculopathies. Neuroimaging Clin N Am. 2024;34(1):13-21. DOI: 10.1016/j.nic.2023.06.001

3. Maher MD, Douglas VP, Douglas KAA, Collens SI, Gilbert AL, Torun N, et al. Clinical and neuroradiologic characteristics in varicella zoster virus reactivation with central nervous system involvement. J Neurol Sci. 2022;437:120262. DOI: 10.1016/j.jns.2022.120262

4. Gilden D, Nagel M, Cohrs R, Mahalingam R, Baird N. Varicella zoster virus in the nervous system. F1000Res. 2015;4(Faculty Rev-1356):1356. DOI: 10.12688/f1000research.7153.1

5. Grahn A, Studahl M. Varicella-zoster virus infections of the central nervous system – Prognosis, diagnostics and treatment. J Infect. 2015;71(3):281-93. DOI: 10.1016/j.jinf.2015.06.004

6. Nagel MA, Gilden D. Neurological complications of varicella zoster virus reactivation. Curr Opin Neurol. 2014;27(3):356-60. DOI: 10.1097/WCO.0000000000000092

7. Bakradze E, Kirchoff KF, Antoniello D, Springer MV, Mabie PC, Esenwa CC, et al. Varicella zoster virus vasculitis and adult cerebrovascular disease. Neurohospitalist. 2019;9(4):203-208. DOI: 10.1177/1941874419845732

8. Nagel MA, Traktinskiy I, Azarkh Y, Kleinschmidt-DeMasters B, Hedley-Whyte T, Russman A et al. Varicella zoster virus vasculopathy: analysis of virus-infected arteries. Neurology. 2011;77(4):364-70. DOI: 10.1212/WNL.0b013e3182267bfa

9. Gilden D. Varicella-zoster virus infections. Continuum (Minneap Minn). 2015;21(6):1692-703. DOI: 10.1212/CON.0000000000000246

10. Carod Artal FJ. Clinical management of infectious cerebral vasculitides. Expert Rev Neurother. 2016;16(2):205-21. DOI: 10.1586/14737175.2015.1134321

11. Kennedy PG, Mogensen TH. Determinants of neurological syndromes caused by varicella zoster virus (VZV). J Neurovirol. 2020;26(4):482-95. DOI: 10.1007/s13365-020-00857-w

12. Chiang F, Panyaping T, Tedesqui G, Sossa D, Costa Leite C, Castillo M. Varicella zoster CNS vascular complications. A report of four cases and literature review. Neuroradiol J. 2014;27(3):327-33. DOI: 10.15274/NRJ-2014-10037

13. Nagel MA, Niemeyer CS, Bubak AN. Central nervous system infections produced by varicella zoster virus. Curr Opin Infect Dis. 2020;33(3):273-8. DOI: 10.1097/QCO.0000000000000647

14. Cheng-Ching E, Jones S, Hui FK, Man S, Gilden D, Bhimraj A, et al. High-resolution MRI vessel wall imaging in varicella zoster virus vasculopathy. J Neurol Sci. 2015;351(1-2):168-73. DOI: 10.1016/j.jns.2015.02.017

15. Langan SM, Minassian C, Smeeth L, Thomas SL. Risk of stroke following herpes zoster: a self-controlled case-series study. Clin Infect Dis. 2014;58(11):1497-503. DOI: 10.1093/cid/ciu098

16. Nagel MA, Gilden D. Developments in varicella zoster virus vasculopathy. Curr Neurol Neurosci Rep. 2016;16(2):12. DOI: 10.1007/s11910-015-0614-5

17. Ministério da Saúde (BR). Secretaria de Vigilância em Saúde e Ambiente. Departamento de Imunizações e Doenças Imunopreveníveis. Manual dos Centros de Referência para Imunobiológicos Especiais [Internet]. 6ª ed. Brasília: Ministério da Saúde; 2023; [acesso em 31 de janeiro de 2024]. Disponível em: https://sbim.org.br/images/calendarios/manual-dos-centros-de-referencia-para-imunobiologicos-especiais-6a-edicao-2023.pdf

Downloads

Published

2024-06-14

How to Cite

Freitas, L. V., Britto, Z. M. L., Rocha, A. B. M., & Ernandes, B. C. (2024). Weil’s syndrome: from various organic dysfunctions to a favorable outcome. Infections in Evidence, 3, e20240438. https://doi.org/10.5935/2764-734X.e20240438

Issue

Vol. 3 (2024)

Section

Case Reports

License

Copyright (c) 2025 Infections in Evidence

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

The Copyright Transfer Agreement assumes that the authors are the legitimate holders of the copyright of the Case Report in question, without infringing any copyright, trademark or patent of others. In this way, they transfer all rights to this manuscript or any revision, version or translation of it to the Journal, including here the exclusivity of its eventual commercialization, provided that in accordance with ethical and moral precepts and relevant Brazilian legislation. All articles in the INFECTIONS IN EVIDENCE Journal are published under the terms of international license 4.0 of the Creative Commons Attribution, which allows users to freely read, download, share and adapt cultural and scientific productions, provided that due credit is given to the original authors and publication.
The Copyright Transfer Agreement also understands that the authors guarantee that the respective Case Report has never been published in another communication vehicle or scientific journal. Papers presented at meetings and/or scientific congresses may be published in the electronic journal INFECTIOUS DISEASES IN EVIDENCE - Case Reports, provided that they have not been published in whole or in part in their Proceedings or Annals.