Leptospirosis (Weil's syndrome) with renal failure, severe jaundice, disseminated haemorrhages and xanthopsia

We report a case of a 48-year-old man from western Austria with severe lept ospirosis. This disease occurs worldwide but predominates in the tropics. T he infectious urine of a wide variety of domestic and wild animals mediates transmission of the infection, which characteristically has a biphasic pat tern. It begins with the "leptospiraemic phase" with high fever, conjunctiv al suffusion, muscle pain and headache. Hepatitis, nephritis and haemorrhag es may follow. The second "immune phase" has a greater variety of clinical manifestations. Fever and the initial symptoms may recur and the central an d peripheral nervous system may be involved. The patient reported showed al l major characteristics except conjunctival suffusion. The outcome was favo urable despite some conditions with a poor prognosis (jaundice, renal failu re, haemorrhages). The extreme severity of jaundice and the xanthopsia (yel low vision) make the case unique.