Fulminant course of leptospirosis complicated by multiple organ failure

We describe a case of a 39-year-old male, who initially presented with seve re muscle pain, fever, shortness of breath and tachycardia. He was admitted to hospital with suspected myocarditis. The next days he developed a gener alized icterus and acute renal failure. Suspecting leptospirosis an intrave nous therapy with penicillin was started. Due to pulmonary and circulatory insufficiency intensive care was necessary. In course the patient developed all known manifestations of leptospirosis including, cardic arrhythmia and asystolia due to AV-block lll, recurrent atelectases of the lungs, hyperbi lirubinemia, thrombocytopenia, hepatitis, pancreatitis, very severe rhabdom yolysis and polyradiculitis with areflexia and tetraplegia. Additionally, t he patient had a transient hyperthyreosis, which has not been described in the literature so far. After 33 days the patient left the intensive care un it and was discharged out of hospital a fortnight later. 4 weeks later he w as able to return to work. The only residuum of this illness is a partial p aresis of his right quadriceps muscle.