Case Report: Multiorgan Leptospirosis (Weil's Disease) in a Young Adult Male with a History of Recurrent Tidal Flood Exposure

Abstract

Leptospirosis is a bacterial zoonotic disease caused by spirochetes of the genus Leptospira and belongs to the group of Neglected Tropical Diseases that often go undiagnosed, particularly in areas with a history of flooding. This case report presents a 20-year-old man who presented with a five-day history of weakness prior to hospital admission, accompanied by persistent fever, nausea, vomiting with every meal, and dizziness, with a history of repeated flood exposure in his residential environment. Physical examination revealed a generally ill appearance, bilateral icteric sclera, anemic conjunctiva, and jaundice of the skin. Laboratory findings showed progressive leukocytosis, thrombocytopenia, mild anemia, hyponatremia, hypokalemia, and elevated urea and creatinine levels that improved during treatment, as well as hyperbilirubinemia with a cholestatic pattern and mild elevations in SGOT/SGPT. Serological testing for Leptospira yielded positive results, while HBsAg, Anti-HCV, and HIV tests were negative. Chest radiography demonstrated findings consistent with bronchopneumonia, while abdominal ultrasonography showed increased cortical echogenicity of both kidneys suggestive of a chronic process, accompanied by cystitis and bilateral pleural effusion. The patient was diagnosed with severe leptospirosis (Weil's disease) complicated by acute kidney injury and bronchopneumonia, and received intravenous ceftriaxone antibiotic therapy, hemodialysis, and supportive management, with subsequent clinical and laboratory improvement. This case underscores the importance of maintaining early clinical suspicion for leptospirosis in patients with a history of flood exposure, given that delayed diagnosis and management are closely associated with a worsening prognosis.