An atypical travel-related infection from Jamaica to Canada

Background: A fever in a returned traveller broadens the possible differential diagnosis for clinicians and can include unfamiliar diseases, making a diagnosis more challenging. Leptospirosis is a worldwide tropical zoonotic infection caused by the bacteria Leptospira. Most cases are mild but can progress to life-threatening infections without appropriate treatment. The severe form of the illness, sometimes called Weil's disease, can cause multiorgan dysfunction with high mortality rates. Methods: This case describes the presentation of a 16-year-old male patient with febrile illness upon returning to Canada from Jamaica. He was managed in an ICU setting for sepsis with severe pain and signs of rhabdomyolysis, hyperbilirubinemia, and renal dysfunction. He was empirically treated with broad-spectrum antibiotics, and a comprehensive infectious workup was sent to identify the responsible pathogen. Results: A polymerase chain reaction (PCR) assay was used to confirm the diagnosis of leptospirosis, and the patient recovered with appropriate antibiotic treatment. Incidentally, the patient was seropositive for prior arbovirus infection. Conclusions: This report documents the first PCR-confirmed case of human leptospirosis in the province of Nova Scotia, Canada, and highlights the potentially severe nature of the disease. Early suspicion is crucial for a positive clinical outcome, and leptospirosis should be on the differential for any febrile traveller returning from an endemic area.