A total of 120 patients were examined presenting with a grave course of icterohemorrhagic leptospirosis; a pathomorphologic investigation of the brain from 75 deceased was done. Practically in all cases, the affection was accompanied by neurotoxicosis, with microcirculatory disturbances being its morphological substrate. The leading clinical syndromes of the affection of the central nervous system appeared to be general cerebral, meningeal, and encephalitic syndromes. Meningitis was diagnosed in 29.2%, meningoencephalitis in 5% of patients. Morphologic studies showed that predominantly focal serous meningitides and meningoencephalitides are significantly more common that they are diagnosed in clinical settings. They tend to develop during the second and third weeks of the course of the illness. Lumbal puncture is to be carried out on a differentiated basis only, since it may cause dysbalance in metabolic processes of the organism together with progression of those events being related to brain swelling.

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