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Case report
Weil’s disease in a young homeless man living in Lisbon
  1. Torcato Moreira Marques1,
  2. Paula Oliveira Nascimento1,
  3. André Almeida1,2 and
  4. Valentina Tosatto1
  1. 1Internal Medicine Department, Hospital de Santa Marta, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
  2. 2NOVA Medical School, Faculdade de Ciências Médicas da Universidade NOVA de Lisboa, Lisboa, Portugal
  1. Correspondence to Dr Torcato Moreira Marques; torcato.marques{at}chlc.min-saude.pt

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.

  • infectious diseases
  • exposures
  • intensive care
  • infections
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Footnotes

  • Contributors PON and AA were the clinicians responsible for the patient during his admission; TMM and VT review the case and assembled the article which was revised by the above-mentioned doctors. TMM applied the consent form and the patient himself signed it.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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