This article is an answer to the Case – Fever, Vomiting, Diarrhea and Subconjunctival Bleeding
A severe form of leptospirosis that manifests as fever, jaundice, renal failure, and hemorrhage was suspected on the basis of the patient’s classic presentation (including the subconjunctival bleeding) and exposure to water with probable contamination by rodent urine. Empirical treatment with intravenous penicillin was initiated.
Analysis for IgM antibodies against leptospira species revealed a titer of 1:320 (reference value, negative). Serum nucleic acid amplification testing was positive for leptospira species, and microscopic agglutination testing later identified Icterohaemorrhagiae as the infecting serogroup.
The patient was discharged after a 1-week hospital stay. At follow-up 3 weeks later, his symptoms, subconjunctival hemorrhage, and liver and kidney injury had resolved.