Also known as Weil's disease, leptospirosis is commonly seen in questions referring to sewage workers, farmers, vets or people who work in an abattoir. It is caused by the spirochaete Leptospira interrogans (serogroup L icterohaemorrhagiae), classically being spread by contact with infected rat urine. Weil's disease should always be considered in high-risk patients with hepatorenal failure

Clinical features

  • Fever
  • Flu-like symptoms
  • Renal failure (seen in 50% of patients)
  • Jaundice
  • Subconjunctival haemorrhage
  • Headache, may herald the onset of meningitis


  • High-dose benzylpenicillin or doxycycline