Severe leptospirosis (Weil’s disease) presenting with pulmonary hemorrhage syndrome and acute kidney injury

Abstract

Leptospirosis is a globally prevalent zoonotic infection with a wide clinical spectrum. Weil’s disease represents a severe form of leptospirosis characterized by jaundice, acute kidney injury (AKI), and hemorrhagic manifestations. Pulmonary hemorrhage is an uncommon but potentially fatal complication. We report the case of a 62-year-old man who presented with acute febrile illness, hemoptysis, jaundice, and AKI. Investigations revealed thrombocytopenia, leukocytosis, severe azotemia, and positive Leptospira immunoglobulin M serology, while dengue and malaria were excluded. He was diagnosed with severe leptospirosis complicated by pulmonary hemorrhage syndrome. The patient was managed with doxycycline, broad-spectrum antibiotics, and supportive care, resulting in complete clinical recovery with normalization of renal function. This case highlights the importance of early recognition of pulmonary involvement in leptospirosis, as timely treatment and supportive care may improve outcomes.