Leptospirosis is a bacterial zoonotic disease caused by Leptospira species, commonly transmitted through direct or indirect contact with contaminated water, soil, or animal urine. Although typically a self-limiting illness, severe forms of leptospirosis (Weil’s disease) can lead to multi-organ dysfunction, including hepatic and renal failure, hemorrhagic manifestations, and altered mental status. This case report describes a 52-year-old male who presented with severe jaundice, nausea, vomiting, diarrhea, and multi-organ dysfunction, including acute kidney injury, liver failure, and thrombocytopenia, following a recent history of fever and self-medication. Initial investigations revealed elevated inflammatory markers, liver enzymes, renal dysfunction, and thrombocytopenia, raising suspicion for leptospirosis. Empiric treatment with doxycycline was initiated, and the diagnosis was confirmed via positive Leptospira IgM (Enzyme-Linked Immunosorbent Assay - ELISA) testing. Despite the severe nature of the illness, the patient showed gradual recovery following supportive care, including hemodialysis and liver protection strategies. This case underscores the importance of early recognition and empirical treatment of leptospirosis in severe cases, as timely intervention can significantly improve outcomes and highlights the need for public health strategies targeting reservoir control and community awareness to avoid its outbreak in the community. Early diagnosis and intensive supportive care, including organ-specific management, are critical for mitigating the high morbidity and mortality associated with multi-organ dysfunction in leptospirosis.
Merhi et al. (Wed,) studied this question.