A 45-year-old man presents with fever, jaundice, myalgia, and haematuria 2 weeks after wading in floodwaters in Kerala. Leptospira-specific IgM ELISA is positive (titre 1:200). Blood urea is 80 mg/dL and bilirubin is 12 mg/dL. What complication and clinical syndrome does this represent?

• A Anicteric leptospirosis — the milder self-limiting form
• B Canicola fever — associated with dog exposure and predominantly AKI without jaundice
• C Fort Bragg fever — peritibial rash variant of leptospirosis
• D Weil's disease — severe leptospirosis with jaundice, acute kidney injury, and haemorrhage ✓

Explanation

Weil's disease (severe leptospirosis) is characterised by the classic triad of jaundice, acute kidney injury (AKI), and haemorrhage (due to endothelial damage and thrombocytopaenia). It is caused by L. interrogans serogroup Icterohaemorrhagiae and has a mortality of 5-15%. Anicteric leptospirosis is the mild self-limiting form (90% of cases) presenting with influenza-like illness without organ failure. Kerala floods are a common context for leptospirosis in India. Treatment is IV penicillin G or ceftriaxone for severe disease.

Reference: Ananthanarayan & Paniker's Textbook of Microbiology, 11th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.