# Severe Leptospirosis With Multi-Organ Dysfunction Syndrome in a Non-Endemic Region: A Case Report

## TL;DR

A man from a non-endemic region developed severe leptospirosis after traveling to an endemic area, showing the disease can occur outside typical regions.

## Contribution

This case report emphasizes leptospirosis as a potential cause of severe illness in non-endemic regions.

## Key findings

- The patient showed septic shock, acute kidney injury, and multi-organ dysfunction consistent with leptospirosis.
- The patient improved with supportive care and antibiotics after leptospirosis was suspected based on travel and symptoms.
- Leptospirosis should be considered in febrile illness with jaundice and organ dysfunction, even in non-endemic areas.

## Abstract

Leptospirosis is a common zoonotic infection worldwide but remains rare in the Middle East, including the United Arab Emirates. We report a case of a 36-year-old male who presented with high-grade fever, severe myalgia, headache, vomiting, dark urine, and altered mental status following recent travel from an endemic area where he worked as a paddy field farmer. Clinical examination and laboratory findings revealed septic shock, acute kidney injury, marked hyperbilirubinemia, and severe thrombocytopenia, consistent with multi-organ dysfunction syndrome. Based on the clinical presentation and exposure history, leptospirosis was strongly suspected, and Leptospira IgM serology was sent. The patient was managed in the intensive care unit with supportive care and broad-spectrum antibiotics, leading to gradual clinical improvement. This case highlights the need to consider leptospirosis in acute febrile illness with jaundice and organ dysfunction, even in non-endemic regions.