Veno-venous extracorporeal membrane oxygenation support for severe leptospirosis complicated by pulmonary hemorrhage and refractory acute respiratory distress syndrome: A case report and literature review.

PATIENT CONCERNS: A 58-year-old male farmer presented with high fever, myalgia, and rapidly progressive dyspnea following possible environmental exposure.

He developed severe hypoxemia accompanied by diffuse pulmonary hemorrhage and multi-organ dysfunction.

INTERVENTIONS: Despite lung-protective mechanical ventilation and adjunctive prone positioning, hypoxemia persisted.

Veno-venous extracorporeal membrane oxygenation was initiated as rescue therapy using an individualized anticoagulation strategy.