Keywords: Leptospirosis, Weil’s disease, jaundice, AKI, pulmonary haemorrhage, sepsis, fever.
A 48-year-old previously well woman presented to the Emergency Department with a 7-day history of fever, myalgia, and nausea, progressing over the past 24 hours to increasing fatigue, jaundice, and oliguria.
Past Medical History:
- No known medical conditions
- No regular or over-the-counter medications
- Non-smoker, does not consume alcohol
Social History:
- Works as a cattle farmer
- Active lifestyle, enjoys wild swimming in a local river.
- No recent foreign travel
Initial Assessment:
On ICU admission:
- Temperature: 39.4°C
- Heart rate: 120 bpm
- Blood pressure: 85/45 mmHg
- Respiratory rate: 20 bpm
- Oxygen saturations: 86% on 2L O₂ via nasal cannula
Examination findings of note:
- Chest: Clear auscultation, occasional dry cough
- Abdomen: Soft but tender, mild hepatomegaly
- Other: Marked jaundice, conjunctival suffusion, oliguric (5–10 ml/hr urine output)
