A 32-year-old male agricultural worker presents with high fever, severe headache, myalgia and marked redness of both eyes without discharge or visual loss. He reports wading through flood water two weeks ago. Which physical finding, if present, would most strongly support the suspected diagnosis over scrub typhus and dengue?

• A Generalised lymphadenopathy
• B Retro-orbital pain
• C Eschar at the axilla
• D Conjunctival suffusion ✓

Explanation

Conjunctival suffusion, a bilateral painless reddening of the bulbar conjunctiva without purulent discharge, is a classical and highly characteristic sign of leptospirosis and helps separate it from other febrile illnesses in the same geographic setting. An eschar points to scrub typhus, retro-orbital pain suggests dengue, and generalised lymphadenopathy is nonspecific across these infections.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.