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Peer-reviewedCC BYFrontiers in medicine

Case Report: Liangxue Jiedu Huayu Formula as adjunctive therapy for leptospirosis with Weil's syndrome.

4 affiliations
  1. 1Department of Infectious Diseases, The People's Hospital of Xiangtan County, Xiangtan, China.
  2. 2Department of Radiology, The People's Hospital of Xiangtan County, Xiangtan, China.
  3. 3Department of Hepatology/Infectious Diseases, The First Hospital of Hunan University of Chinese Medicine, Changsha, China.
  4. 4Hunan University of Chinese Medicine, Changsha, China.

Abstract

Background

Leptospirosis is a global zoonotic disease with over one million cases annually worldwide. Approximately 5%-10% of patients progress to Weil's syndrome, characterized by multi-organ failure and high mortality, but treatment options remain limited. This report describes a patient with severe leptospirosis who showed marked improvement following treatment with Liangxue Jiedu Huayu Formula (LXJDHYF), a traditional Chinese medicine formula, and explores potential mechanisms.Case presentation

A 54-year-old male farmer developed high fever, jaundice, acute kidney injury, and early disseminated intravascular coagulation after working in a lotus pond. Leptospirosis was confirmed by a four-fold rise in MAT titer from 1:50 to 1:200. Despite initial treatment with conventional therapies including antibiotics, continuous renal replacement therapy, and plasma infusion, the patient remained febrile with persistently elevated white blood cell and bilirubin levels. From day 5 of hospitalization, LXJDHYF was added. Fever gradually subsided, total bilirubin progressively decreased, serum creatinine eventually normalized, and coagulation function returned to normal. At 6-month follow-up, the patient had fully recovered.Mechanistic exploration

Network pharmacology identified 14 common targets, including ICAM1, SELE, TLR4, and SERPINE1. KEGG enrichment revealed pathways related to TLR4/NF-κB signaling, cytokine-cytokine receptor interaction, and complement/coagulation cascades. Molecular docking showed strong binding affinities (≤ -7.0 kcal/mol) between core components (cryptotanshinone, nortanshinone, rhein, naringenin) and core targets (TLR4, ICAM1, ALB). These computational findings are hypothesis-generating and require experimental validation.Conclusion

This case suggests that adjuvant treatment with LXJDHYF may be beneficial for leptospirosis complicated by Weil's syndrome, based on conventional therapy. Network pharmacology has generated testable hypotheses regarding multi-target modulation of inflammatory, adhesion, and coagulation pathways. These computational findings require experimental validation.

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BibTeX
@article{li2026case,
  title = {{Case Report: Liangxue Jiedu Huayu Formula as adjunctive therapy for leptospirosis with Weil's syndrome.}},
  author = {Meixuan Li and Wenbin Huang and Mian Zhao and Qiao Zhuang and Xue Zhang and Yunan Wu},
  journal = {Frontiers in medicine},
  year = {2026},
  month = oct,
  doi = {10.3389/fmed.2026.1905508},
  url = {https://europepmc.org/article/MED/42923073},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Case Report: Liangxue Jiedu Huayu Formula as adjunctive therapy for leptospirosis with Weil's syndrome.
AU  - Meixuan Li
AU  - Wenbin Huang
AU  - Mian Zhao
AU  - Qiao Zhuang
AU  - Xue Zhang
AU  - Yunan Wu
PY  - 2026
DA  - 2026/10/08
JO  - Frontiers in medicine
DO  - 10.3389/fmed.2026.1905508
UR  - https://europepmc.org/article/MED/42923073
AB  - Background  Leptospirosis is a global zoonotic disease with over one million cases annually worldwide. Approximately 5%-10% of patients progress to Weil's syndrome, characterized by multi-organ failure and high mortality, but treatment options remain limited. This report describes a patient with severe leptospirosis who showed marked improvement following treatment with Liangxue Jiedu Huayu Formula (LXJDHYF), a traditional Chinese medicine formula, and explores potential mechanisms.Case presentation  A 54-year-old male farmer developed high fever, jaundice, acute kidney injury, and early disseminated intravascular coagulation after working in a lotus pond. Leptospirosis was confirmed by a four-fold rise in MAT titer from 1:50 to 1:200. Despite initial treatment with conventional therapies including antibiotics, continuous renal replacement therapy, and plasma infusion, the patient remained febrile with persistently elevated white blood cell and bilirubin levels. From day 5 of hospitalization, LXJDHYF was added. Fever gradually subsided, total bilirubin progressively decreased, serum creatinine eventually normalized, and coagulation function returned to normal. At 6-month follow-up, the patient had fully recovered.Mechanistic exploration  Network pharmacology identified 14 common targets, including ICAM1, SELE, TLR4, and SERPINE1. KEGG enrichment revealed pathways related to TLR4/NF-κB signaling, cytokine-cytokine receptor interaction, and complement/coagulation cascades. Molecular docking showed strong binding affinities (≤ -7.0 kcal/mol) between core components (cryptotanshinone, nortanshinone, rhein, naringenin) and core targets (TLR4, ICAM1, ALB). These computational findings are hypothesis-generating and require experimental validation.Conclusion  This case suggests that adjuvant treatment with LXJDHYF may be beneficial for leptospirosis complicated by Weil's syndrome, based on conventional therapy. Network pharmacology has generated testable hypotheses regarding multi-target modulation of inflammatory, adhesion, and coagulation pathways. These computational findings require experimental validation.
SN  - 2296-858X
ER  -