# Through the Haze of Hemorrhage: Unraveling Leptospirosis With Diffuse Alveolar Hemorrhage

## TL;DR

This paper presents a case of severe leptospirosis complicated by lung bleeding, highlighting the importance of clinical suspicion and repeat testing for accurate diagnosis.

## Contribution

The case highlights the rare complication of diffuse alveolar hemorrhage in leptospirosis and the diagnostic challenges due to initial negative serology.

## Key findings

- The patient presented with diffuse alveolar hemorrhage, acute kidney injury, and liver dysfunction due to severe leptospirosis.
- Initial serology was negative, but repeat testing confirmed Leptospira IgM positivity.
- The patient improved with antibiotics and supportive care, underscoring the need for clinical vigilance in severe cases.

## Abstract

Leptospirosis is a zoonotic infection caused by Leptospira species, presenting with a wide spectrum of clinical manifestations ranging from mild febrile illness to severe multi-organ dysfunction, also known as Weil’s disease. This case describes a patient with severe leptospirosis complicated by diffuse alveolar hemorrhage, acute kidney injury, hepatic dysfunction, and thrombocytopenia. The diagnosis was initially challenging due to negative serology in the early phase of the illness, but strong clinical suspicion led to a repeat Leptospira IgM positivity. Later, the diagnosis was confirmed with the microscopic agglutination test. The patient responded well to antibiotic therapy and supportive care, emphasizing the importance of clinical suspicion and repeat testing in severe cases of leptospirosis.