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Introduction: Leptospirosis is a worldwide zoonosis caused by the spirochete Leptospira interrogans. The spectrum of symptoms reported in leptospirosis is extremely broad. Thrombocytopenia is common during the acute phase of leptospirosis but its pathophysiological mechanism remains not well defined., Case Report: We report a 56-year-old man hospitalized for severe sepsis with acute kidney injury and liver failure. Because of the recent flood of his house, we suspected leptospirosis. The diagnosis was rapidly confirmed. Blood tests revealed thrombocytopenia at 9 G/L associated with hyperferritinemia and hypertriglyceridemia. Cytological examination of bone marrow showed abundance of megakaryocytes and hemophagocytosis which confirmed the diagnosis of hemophagocytic syndrome. Clinical symptoms resolved and blood tests returned to normal values in the same time., Conclusion: We suggest that hemophogocytosis is a possible mechanism of thrombocytopenia in leptospirosis and that examination of bone marrow should be performed to confirm the diagnosis., (Copyright © 2014. Published by Elsevier SAS.)

From January 1, 1987 through December 31, 1990, twenty-four pediatric patients with human parvovirus B19 (HPV B19) infection were seen. In every case the diagnosis was established by a positive capture immunoassay for IgM antibodies against the HPV B19. Four patients had hematologic manifestations, including one case of transient bone marrow aplasia revealing hereditary spherocytosis, one case of autoimmune hemolytic anemia with beta-thalassemia, and two cases of peripheral thrombocytopenia. Eight patients had skin lesions, with a morbilliform rash in six cases, erythema nodosum in one case, and Gianotti-Crosti syndrome in one case. No patients had erythema infectiosum. Seven patients developed joint manifestations: Henoch-Schönlein purpura in two cases, arthralgia in four cases, and polyarticular disease progressing to severe rheumatoid arthritis in a thirteen-year-old girl. Unremarkable symptoms of viral disease were seen in three patients. A five-month-old infant developed severe acute myocarditis. One patient with hepatitis A had acute liver failure. This study confirms the broad spectrum of clinical manifestations of HPV B19 infection. There were a number of unusual findings, including the high rate of joint manifestations (29%) and the severe course of some hematologic and myocardial manifestations. These results raise the question of whether the HPV B19 may be involved in the genesis of chronic juvenile arthritis.

Three cases of thrombocytopenia in pregnant women are described. Two of these patients had an AIDS-like illness and the third one had AIDS. This HIV-associated change occurred in 8% of the complications of a consecutive series of 38 pregnant women who were positive for the HIV antibody test in the course of one year. A link with HIV was established after eliminating idiopathic pregnancy thrombocytopenic purpura and after eliminating every other viral cause for the thrombocytopenia. The normal myelogram speaks in favour of a peripheral origin for the platelet destruction. Treatment consisted in administering immunoglobulins intravenously in a continuous transfusion in doses of 0.04 g/kg per day. The method was effective in two cases. Three cesareans were carried out. In two cases the recovery was uncomplicated and in the third case the haemorrhagic syndrome developed immediately after delivery. This patient died 35 days after delivery. Fetal scalp blood or fetal cord blood could not be taken in any of these three cases. The newborn did not have thrombocytopenia at birth, but they did have anti-IVF antibodies and one of them developed and AIDS-like syndrome. The time interval has not been long enough to assess the further development in the two other cases. The survivors are being followed up with a threefold assessment of the blood picture, the immunological state and the virology. This is being done on the two surviving mothers and the three infants.