A previously well 62-year-old male from North Queensland presented with lep
tospirosis featuring fever, renal failure, hepatitis and pulmonary haemorrh
age. Management was greatly complicated by severe and previously unrecogniz
ed aortic stenosis with a peak valve gradient of 125mmHg. A successful outc
ome followed careful haemodynamic managment and treatment of the infective
illness with subsequent valve replacement.