W. Fuchs et al., Leptospirosis (Weil's syndrome) with renal failure, severe jaundice, disseminated haemorrhages and xanthopsia, SCHW MED WO, 129(22), 1999, pp. 847-850
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.