Leptospirosis beyond the Classic Triad: Fanconi-like Syndrome and Aseptic Meningitis in an Immunocompetent Adult

pale, anicteric, with bipedal edema and no lymphadenopathy.System examination revealed normal breath sounds with no added sounds over bilateral lung fields and normal cardiac auscultation with no murmurs.Abdomen was soft and nontender with no organomegaly.Clinically, he had terminal neck stiffness but no focal neurological deficit, and Kernig's and Brudzinski's signs were both negative.Lab tests at admission revealed mild normocytic anemia (hemoglobin-10.2gm/dL, range 13-17 gm/dL), normal white cell counts, and low-normal platelet count (platelet count-1.50lakhs/ mm 3 ), with normal renal and hepatic parameters but a myriad of electrolyte abnormalities-hyponatremia (sodium-119 mEq/L, range 133-146 mEq/L), hypocalcemia (corrected calcium-8 mg/ dL, range 8.5-10.5 mg/dL), hypophosphatemia (phosphorus-1.5 1,