PMC6308378_01
Kidney biopsy specimen. Grocott's methenamine silver staining revealing inclusions (arrows) resembling Leptospira in the lumen of renal tubules (original magnification x100).
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Using Grocott's methenamine silver staining protocol, cellular inclusions resembling intact Leptospira were found in the tubular lumen of the kidney biopsy specimen (Figure 1).
Graph showing serum creatinine and total bilirubin levels during treatment. Treatment regimen: Biotaksime 2 x 1 g i.v. 28.09 to 21.10.2016; methylprednisolone (250 mg) i.v. 14 to 16.10.2016; Encortone 20 mg orally 17.10.2016; hemodialysis sessions (8 in total) 28.08, 30.09, 02.10, 04.10, 08.10, 12.10, 14.10, and 17.10.2016; plasmapheresis sessions (2 in total) 27.09 and 29.09.2016.
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This resulted in a marked increase in the patient's urinary output, which rose up to 6000 ml per day, accompanied by a continuous drop in serum creatinine and bilirubin levels (Figure 2).