Weil's syndrome

Introduction

Severe leptospirosis characterized by jaundice, renal failure & hemorrhage. Mortality is high.

Clinical manifestations

• onset of illness similar to less severe cases of leptospirosis
• jaundice, renal failure & hemorrhage develop after 4-9 days
• hepatomegaly & right upper quadrant tenderness
• splenomegaly (20%)
• renal failure often develops in 2nd week
  • acute tubular necrosis (ATN)
  • dialysis may be required
  • renal function may completely recover
• pulmonary involvement
  • cough
  • dyspnea
  • chest pain
  • blood-tinged sputum
• hemorrhagic manifestations
  • epistaxis
  • petechiae
  • purpura
  • ecchymoses
  • severe GI bleeding, adrenal & subarachnoid hemorrhage rare
• other manifestations:
  • rhabdomyolysis, hemolysis, pericarditis, congestive heart failure (CHF), cardiogenic shock, adult respiratory distress syndrome, multiorgan failure

Management

• penicillin G 1.5 million units IV QID for 7 days
• ampicillin 1 g IV QID for 7 days
• erythromycin 1 g IV QID for 7 days

More general terms

• leptospirosis
• liver disease
• renal failure; kidney failure
• lung disease
• syndrome

Additional terms

• Leptospira