Severe Leptospirosis (Weil’s Disease) with Multi-Organ Failure: A Case Series

Abstract

Weil’s disease, the severe form of leptospirosis, poses a significant clinical challenge due to its potential for rapid multi-organ failure. This case series reports four patients presenting with fever, profound jaundice, myalgia, and dark urine. Laboratory evaluations revealed hyperbilirubinemia, thrombocytopenia, and leukocytosis in all subjects, with acute kidney injury complicating three cases. Diagnosis was confirmed via IgM Leptospira serology. Following empirical antibiotic treatment and supportive care, three patients achieved full recovery. However, one patient experienced rapid clinical deterioration leading to fatal septic shock. These cases underscore the diverse clinical spectrum of leptospirosis, ranging from manageable organ dysfunction to life-threatening systemic collapse. The findings emphasize that early clinical suspicion and prompt initiation of empirical therapy are paramount to reducing mortality, particularly in settings where distinguishing Weil’s disease from other acute febrile illnesses remains difficult.