Hemorrhagic fever with renal syndrome and leptospirosis: Differential diagnosis

V. I. Starostina, A. Zh. Gilmanov, G. R. Latypova
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Abstract

Hemorrhagic fever with renal syndrome and leptospirosis have similarities and differences in the clinical picture. Fever, intoxication, pronounced kidney damage and hemorrhagic syndrome are observed in both infections. The course of these diseases may be complicated by the development of infectious-toxic shock, acute renal failure, disseminated intravascular coagulation. Clinical manifestations of the syndrome of jaundice and meningitis may be observed in leptospirosis, but are not characteristic of hemorrhagic fever with renal syndrome. In leptospirosis, in contrast to hemorrhagic fever with renal syndrome, liver failure may develop. Infection with these diseases often occurs during a stay in a forest, in a holiday home, in rural areas. The natural foci of these infections may be located on the same territories or border each other, which also complicates the differential diagnostics. The article provides information on the etiology, epidemiology, geographical distribution, pathogenesis, pathological anatomy, clinical picture and diagnostics of hemorrhagic fever with renal syndrome and leptospirosis. Based on these data, the pathophysiological, clinical and laboratory aspects of the differential diagnosis between these diseases are analyzed in detail.
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肾综合征出血热和钩端螺旋体病:鉴别诊断
肾综合征出血热与钩端螺旋体病在临床表现上有异同。两种感染均出现发热、中毒、明显肾损害和出血性综合征。这些疾病的病程可并发感染性中毒性休克、急性肾功能衰竭、弥散性血管内凝血。钩端螺旋体病可以观察到黄疸和脑膜炎综合征的临床表现,但不是肾综合征出血热的特征。钩端螺旋体病,与肾综合征出血热不同,可发展为肝功能衰竭。这些疾病的感染通常发生在住在森林、度假屋和农村地区期间。这些感染的自然疫源地可能位于同一地区或彼此接壤,这也使鉴别诊断复杂化。本文介绍了肾综合征出血热和钩端螺旋体病的病因学、流行病学、地理分布、发病机制、病理解剖、临床表现和诊断。在此基础上,从病理生理、临床和实验室等方面对两种疾病的鉴别诊断进行了详细的分析。
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