Moreira Marques, TNascimento, PAlmeida, ATosatto, V2022-04-282022-04-282020BMJ Case Rep. 2020 Jun 11;13(6):e233543.http://hdl.handle.net/10400.17/4050Leptospirosis 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.engHSM MEDAdultHumansMaleAdministration, IntravenousAnti-Bacterial Agents / administration & dosageCeftriaxone / administration & dosage*Critical Care / methodsDiagnosis, DifferentialEnvironmental Exposure* / adverse effectsEnvironmental Exposure* / analysisFluid Therapy / methodsHomeless PersonsKidney Function TestsLeptospira interrogans / isolation & purification*Liver Function TestsMultiple Organ Failure* / diagnosisMultiple Organ Failure* / etiologyThrombocytopenia* / diagnosisThrombocytopenia* / etiologyTreatment OutcomeWeil Disease* / bloodWeil Disease* / diagnosisWeil Disease* / therapyWeil Disease* / drug therapyjournal article10.1136/bcr-2019-233543.