Atypical manifestations of leptospirosis

Trans R Soc Trop Med Hyg. 2015 May;109(5):294-302. doi: 10.1093/trstmh/trv026. Epub 2015 Mar 25.


Leptospirosis is an illness with a wide spectrum of clinical manifestations and severe illness affects nearly all organ systems. Serious and potentially life-threatening clinical manifestations of acute leptospirosis are caused by both direct tissue invasion by spirochaetes and by the host immune responses. In its severe form, leptospirosis can cause multi-organ dysfunction and death in a matter of days. Therefore it is critical to suspect and recognize the disease early, in order to initiate timely treatment. While the classical presentation of the disease is easily recognized by experienced clinicians practising in endemic regions, rarer manifestations can be easily missed. In this systematic review, we summarize the atypical manifestations reported in literature in patients with confirmed leptospirosis. Awareness of these unusual manifestations would hopefully guide clinicians towards early diagnosis.

Keywords: Atypical manifestations; Leptospirosis; Weil's disease.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Diagnosis, Differential
  • Disease Progression
  • Disease Reservoirs
  • Early Diagnosis
  • Humans
  • Leptospira / isolation & purification*
  • Leptospirosis / diagnosis*
  • Leptospirosis / microbiology
  • Leptospirosis / prevention & control