Abstract
Leptospirosis is a zoonosis with protean manifestation caused by the spirochete, Leptospira interrogans. Here we report a 60-year-old male who presented with sudden onset of fever, rigors, myalgia and headache occasionally accompanied by nausea, vomiting and diarrhea. Later during the course of treatment he developed encephalopathy with fulminant hepatic failure and acute kidney injury and was diagnosed as a case of leptospirosis. A timely workup combined with early initiation of antibiotics and hemodialysis led to effective treatment for this patient.
 J Enam Med Col 2019; 9(2): 136-139
Highlights
J Enam Med Col 2019; 9(2): 136–139Leptospirosis is the most widespread zoonosis with complex clinical features varying from subclinical infection and self-limiting anicteric illness to multiple organ failure (MOF) and death
Later during the course of treatment he developed encephalopathy with fulminant hepatic failure and acute kidney injury and was diagnosed as a case of leptospirosis
Severe disease presenting with acute renal failure (ARF) is associated with acute liver failure (ALF) in up to 70% of cases and leads to MOF and death in one-third of the patients despite standard medical treatment.[2,3]
Summary
Leptospirosis is the most widespread zoonosis with complex clinical features varying from subclinical infection and self-limiting anicteric illness to multiple organ failure (MOF) and death. In spite of initial treatment, he developed confusion and became subconscious at the seventh day He was transferred to a Private Medical College Hospital in Dhaka and was immediately shifted to intensive care unit. His physical examination revealed mild anemia, marked jaundice, temperature 1000 F, pulse 100 beats/minute, blood pressure 173/100 mm of Hg and GCS 10/15. On 14.8.16, serum bilirubin was 6.8 mg/ dL, serum creatinine 2.2 mg/dL, blood urea 50 mg/dL, Hb 10.9 gm/dL, WBC 13000/cu mm, neutrophil 78% and platelet count 180000/cu mm He was shifted from ICU to a cabin and continued conservative management and discharged on 15th day of illness with stable mentation and hemodynamics. He was advised to come for follow-up at OPD with repeat liver and renal function tests after one week
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