Leptospirosis complicated by myonecrosis, skin necrosis, dry gangrene of the extremity and multiorgan dysfunction

Abstract

Leptospirosis is a bacterial infection caused by Leptospira species and transmitted through direct contact with infected animals or through exposure to contaminated water or soil. Clinical manifestations range from mild febrile illness to severe multisystem involvement affecting the liver, kidneys, lungs, and muscles. We report a 47-year-old male with severe leptospirosis complicated by multiorgan failure and rare manifestations, including skin necrosis, myonecrosis and dry gangrene of the toes. The patient required intensive care management, including vasopressor support, mechanical ventilation, renal replacement therapy and surgical intervention. Following a prolonged hospital course, he gradually recovered and achieved full functional independence at 18 months of follow-up. This case highlights the importance of early recognition and multidisciplinary management of severe leptospirosis to reduce morbidity and mortality.