Gescout in het water: de Ziekte van Weill

Scouted in the water: Weill's disease In this case report we present a young patient with anicteric leptospirosis, acute renal failure and aseptic meningitis. Leptospirosis, a common zoonosis worldwide, is caused by pathogenic Leptospira species excreted in the urine of mainly rodents. Leptospirosis is uncommon in Belgium, which means there is a risk of late recognition. Although the course of leptospirosis in humans is usually mild and self-limiting, the severe form can cause multiple complications with multi-organ failure and even death. Organ damage occurs both directly by the leptospires themselves and indirectly by immune-mediated mechanisms, causing a vasculitis. A biphasic course is sometimes seen, with the acute leptospiremic phase followed by an immune phase. A rare complication during the immune phase is aseptic meningitis. Early diagnosis and prompt initiation of treatment require a comprehensive knowledge of the clinical presentation of leptospirosis and the risk factors for exposure to leptospirae. This way, the correct antibiotics can be started quickly and complications or death due to leptospirosis can be prevented. Early recognition and treatment of leptospirosis is associated with a good outcome.