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Leptospirosis: a clinical and diagnostic challenge
  1. Jessica Saliba,
  2. Claire Vassallo,
  3. Joseph Saliba and
  4. Michael Pace Bardon
  1. Medicine, Mater Dei Hospital, Msida, Malta
  1. Correspondence to Dr Jessica Saliba; jessica.busuttil{at}


We present the case of a man in his early 50s who presented with a history of fever, malaise and jaundice. Initial investigations showed liver and renal dysfunction with no discernible cause for the septic process. On starting intravenous antibiotics, the patient developed a septic-shock-like reaction requiring transfer to intensive care. A diagnosis of leptospirosis was eventually established through an extensive and thorough history leading to a stepwise approach to investigations. Treatment targeting leptospirosis was delivered with noticeable clinical improvement.

  • Infectious diseases
  • Medical management
  • Pneumonia (respiratory medicine)
  • Acute renal failure
  • Liver disease

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  • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: JeS, CV, JoS and MPB. The following authors gave final approval of the manuscript: JeS, CV, JoS and MPB.

  • 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.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

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