S22 

Leptospirosis: A Rare Cause of Acute Hepatitis  
 

Jo Ann Wong1 

 

 

Abstract 

 

Leptospirosis is a zoonotic infection caused by the pathogenic Leptospira interrogans. Humans 

acquire the infection either through direct contact with the urine of infected animals, commonly 

rats or indirect contact of contaminated water or soil. It is a rare cause of acute hepatitis in the 

UK with fewer than 100 reported cases a year and hence diagnosis is commonly delayed. A 

51-year-old fit Caucasian gentleman was admitted with a one-week history of painless 

jaundice, dark urine and pale-coloured stools. This was associated with feeling unwell, 

anorexia, nausea and intermittent epigastric discomfort. He binges on alcohol on a weekend. 

He works as a telephone engineer which occasionally exposes him to sewage water. On clinical 

examination, he was icteric with mild right hypochondriac tenderness. Liver biopsy was 

performed and histologically it was suggestive of leptospirosis. He was started on a five-day 

course of intravenous ceftriaxone followed by two days course of oral doxycycline. His IgM 

leptospirosis result finally came back as positive. Due to the rarity of leptospirosis in the UK, 

the serological testing of leptospirosis is only performed in the Rare and Imported Pathogens 

Laboratory in Porton Down, Salisbury leading to a delay in getting the result. The patient 

underwent an invasive procedure which can be avoided if the leptospirosis serology was 

ordered early and result available quickly. Fortunately, the patient made a full recovery after 

two months. Leptospirosis should be considered in an individual with acute hepatitis and a 

history of exposure to sewage. 

Keywords: leptospirosis, hepatitis, liver biopsy 

 

1. St James' University Hospital, United Kingdom 

  

DOI: http://dx.doi.org/10.31344/ijhhs.v5i0-2.340  
  

http://dx.doi.org/10.31344/ijhhs.v5i0-2.340