# An Unusual Presentation of Leptospirosis: A Case of Septic Shock and Proteinuria

## TL;DR

This paper reports a rare case of leptospirosis presenting as septic shock and kidney injury in a 57-year-old man, highlighting the disease's unpredictable severity and treatment outcomes.

## Contribution

The novelty lies in documenting an unusual rapid progression of leptospirosis to septic shock and successful treatment with ceftriaxone.

## Key findings

- The patient developed septic shock and acute kidney injury within a day of initial symptoms.
- Ceftriaxone treatment led to full recovery after 14 days.
- Early diagnosis using blood cultures and PCR is critical for managing severe leptospirosis.

## Abstract

Leptospirosis is a global health concern, particularly in tropical regions, with clinical symptoms varying from mild fever to severe organ dysfunction. We present a case of a 57-year-old male with septic shock and acute kidney injury due to acute leptospirosis. The patient's rapid progression to shock within a day of generalized symptoms was unusual. The patient's infection ultimately resolved with ceftriaxone and he was discharged after 14 days of therapy. The pathogenesis of severe leptospirosis is believed to be due to vasculitis, with organ damage caused by the leptospira bacteria and immune-mediated mechanisms. Diagnostic investigations include blood cultures and polymerase chain reactions, which are beneficial for early diagnosis. The management of patients depends on the severity of symptoms and other health conditions, as well as antibiotics and hydration. However, leptospirosis can lead to a wide range of complications, including neurological, ocular, hematological, and gastrointestinal involvement, necessitating vigilant monitoring and management.