Weil's disease in a young homeless man living in Lisbon

BMJ Case Reports
Torcato Moreira MarquesValentina Tosatto

Abstract

Leptospirosis is a zoonotic disease of worldwide distribution caused by infection with Leptospira genus bacteria, a pathogenic spirochaete. We present the case of a 29-year-old man admitted to our hospital with fever and multiorgan failure. He provided poor information about his symptoms. No recent travel or occupational history was reported and his clinical presentation did not suggest any infectious foci. His relatives later disclosed that he had been homeless for 3 weeks in the context of behavioural changes, obtaining foodstuff from waste containers and water from rain puddles. In the setting of this epidemiology, his presentation of fever, jaundice, acute renal injury and thrombocytopaenia suggested leptospirosis. Prompt empirical antimicrobial coverage was started, alongside organ support therapy. The diagnosis was later confirmed through microscopical and molecular methods. The patient made a full recovery. Leptospirosis should be considered early in the diagnostic work-up of any patient with acute febrile illness with multiorgan system involvement, with the identification of risk factors being essential to treat early in development of the disease.

References

Apr 9, 2001·Clinical Microbiology Reviews·P N Levett
Dec 4, 2003·The Lancet Infectious Diseases·Ajay R BhartiUNKNOWN Peru-United States Leptospirosis Consortium
Mar 11, 2010·Virchows Archiv : an International Journal of Pathology·Eduardo Rocha AraujoThales De Brito
Nov 13, 2014·Current Topics in Microbiology and Immunology·David A Haake, Paul N Levett
Sep 17, 2015·Journal of Medical Case Reports·You Me KangTatsuki Uemura
Sep 18, 2015·PLoS Neglected Tropical Diseases·Federico CostaAlbert I Ko

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Citations

Jul 17, 2020·IDCases·Pablo Sanchez FernandezJean-Christophe Lagier

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