{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T23:35:43Z","timestamp":1790033743057,"version":"4.0.1"},"reference-count":13,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,4,19]]},"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:p>Leptospirosis is a zoonotic disease of worldwide distribution caused by infection with <jats:italic>Leptospira<\/jats:italic> genus bacteria, a pathogenic spirochaete. We present the case of a 29-year-old man admitted to our hospital with fever and multiorgan failure. He provided poor information about his symptoms. No recent travel or occupational history was reported and his clinical presentation did not suggest any infectious foci. His relatives later disclosed that he had been homeless for 3 weeks in the context of behavioural changes, obtaining foodstuff from waste containers and water from rain puddles. In the setting of this epidemiology, his presentation of fever, jaundice, acute renal injury and thrombocytopaenia suggested leptospirosis. Prompt empirical antimicrobial coverage was started, alongside organ support therapy. The diagnosis was later confirmed through microscopical and molecular methods. The patient made a full recovery. Leptospirosis should be considered early in the diagnostic work-up of any patient with acute febrile illness with multiorgan system involvement, with the identification of risk factors being essential to treat early in development of the disease.<\/jats:p>","DOI":"10.1136\/bcr-2019-233543","type":"journal-article","created":{"date-parts":[[2020,6,12]],"date-time":"2020-06-12T05:55:15Z","timestamp":1591941315000},"page":"e233543","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Weil\u2019s disease in a young homeless man living in Lisbon"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2820-3259","authenticated-orcid":false,"given":"Torcato","family":"Moreira Marques","sequence":"first","affiliation":[{"name":"Internal Medicine Department, Hospital de Santa Marta, Centro Hospitalar Universit\u00e1rio de Lisboa Central, Lisboa, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula Oliveira","family":"Nascimento","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Hospital de Santa Marta, Centro Hospitalar Universit\u00e1rio de Lisboa Central, Lisboa, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9","family":"Almeida","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Hospital de Santa Marta, Centro Hospitalar Universit\u00e1rio de Lisboa Central, Lisboa, Portugal"},{"name":"NOVA Medical School, Faculdade de Ci\u00eancias M\u00e9dicas da Universidade NOVA de Lisboa, Lisboa, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Tosatto","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Hospital de Santa Marta, Centro Hospitalar Universit\u00e1rio de Lisboa Central, Lisboa, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,6,11]]},"reference":[{"key":"2025082713112916000_13.6.e233543.1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(03)00830-2"},{"key":"2025082713112916000_13.6.e233543.2","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-662-45059-8_5"},{"key":"2025082713112916000_13.6.e233543.3","doi-asserted-by":"publisher","DOI":"10.1016\/S1286-4579(00)01280-6"},{"key":"2025082713112916000_13.6.e233543.4","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.14.2.296-326.2001"},{"key":"2025082713112916000_13.6.e233543.5","first-page":"86","article-title":"An unusual presentation of Weil's disease","volume":"67","author":"Pal","year":"2019","journal-title":"J Assoc Physicians India"},{"key":"2025082713112916000_13.6.e233543.6","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0003898"},{"key":"2025082713112916000_13.6.e233543.7","doi-asserted-by":"crossref","DOI":"10.1186\/1752-1947-5-7","article-title":"Fulminant leptospirosis (Weil's disease) in an urban setting as an overlooked cause of multiorgan failure: a case report","volume":"5","author":"Maroun","year":"2011","journal-title":"J Med Case Rep"},{"key":"2025082713112916000_13.6.e233543.8","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ki.5002393"},{"key":"2025082713112916000_13.6.e233543.9","doi-asserted-by":"publisher","DOI":"10.1007\/s00428-010-0894-8"},{"key":"2025082713112916000_13.6.e233543.10","first-page":"bcr2013201654","article-title":"The dangers of living in a tent in London","volume":"2014","author":"De Butts","year":"2014","journal-title":"Case Rep Child Meml Hosp Chic"},{"key":"2025082713112916000_13.6.e233543.11","doi-asserted-by":"crossref","unstructured":"Kang YM , Hagiwara A , Uemura T . Leptospirosis infection in a homeless patient in December in Tokyo: a case report. J Med Case Rep 2015;9.doi:10.1186\/s13256-015-0687-4","DOI":"10.1186\/s13256-015-0687-4"},{"key":"2025082713112916000_13.6.e233543.12","doi-asserted-by":"publisher","DOI":"10.1089\/vbz.2015.1863"},{"key":"2025082713112916000_13.6.e233543.13","unstructured":"European Centre for Disease Prevention and Control . Annual epidemiological report 2016 \u2013 leptospirosis. 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