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 its severe form, characterized by jaundice, renal failure, and hemorrhagic manifestations. Pulmonary hemorrhage is an uncommon but often fatal complication. We report a 62-year-old male who presented with acute febrile illness, hemoptysis, jaundice, and acute kidney injury. Investigations revealed thrombocytopenia, leukocytosis, severe azotemia, and positive Leptospira IgM 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 can reverse multiorgan dysfunction and improve outcomes.