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Case Report
Fulminant diffuse alveolar hemorrhage in Weil’s disease: A case report
1 Attending Physician, Internal Medicine Service, Hospital Regional Universitario de Colima, IMSS-Bienestar, Colima, Colima, Mexico
2 Attending Physician, Infectology Service, Hospital Regional Universitario de Colima, IMSS-Bienestar, Colima, Colima, Mexico
3 Attending Physician, Neumology Service, Hospital Regional Universitario de Colima, IMSS-Bienestar, Colima, Colima, Mexico
4 Biostatistician and Research Coordinator, Medical Research Department, Medi-Fi, Biostatistics and Research Consultancy, Guadalajara, Jalisco, Mexico
Address correspondence to:
Héctor Escobedo-López
Km 2.0 Colima-Guadalajara Highway, El Porvenir, Colima, Colima, Zip code: 28085,
Mexico
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Article ID: 100022Z16HL2026
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How to cite this article
Escobedo-López H, Sánchez-López G, Cruz-Sánchez S, Gutiérrez-Campos ND, Gómez-Zamora CA, Terrones-Lozano A. Fulminant diffuse alveolar hemorrhage in Weil’s disease: A case report. J Case Rep Images Infect Dis 2026;9(1):19–23.ABSTRACT
Introduction: Leptospirosis is a zoonosis with worldwide distribution. Its severe form (Weil’s disease) is characterized by jaundice, renal dysfunction, and hemorrhagic diathesis. Hemorrhagic pulmonary involvement is a lethal, often underdiagnosed complication.
Case Report: A 34-year-old male farmer was admitted for fever, jaundice, and progressive symmetric muscle weakness in the lower limbs. Initial laboratory tests showed severe thrombocytopenia (5000/μL), acute kidney injury (creatinine 5.9 mg/dL), and hyperbilirubinemia. Despite empirical antibiotic management (doxycycline/ceftriaxone), the patient developed acute respiratory failure secondary to diffuse alveolar hemorrhage confirmed by bronchoscopy and imaging. Mechanical ventilation and hemodialysis were required. Serology (microscopic agglutination test) confirmed leptospirosis. The patient died due to pulmonary complications and multiorgan failure.
Conclusion: Leptospirosis should be considered in the differential diagnosis of patients with a febrile syndrome and muscle weakness in endemic areas. The onset of respiratory symptoms should raise concern for the development of alveolar hemorrhage, which carries an ominous prognosis.
Keywords: Acute respiratory distress syndrome, Leptospirosis, Spirochetal jaundice, Weil’s disease
SUPPORTING INFORMATION
Acknowledgments
Artificial intelligence (AI) use in the article:
Anthropic Claude Sonnet 4.6 (Released on 17-Feb-2026) was used to verify the translation and language used in the manuscript text.
Héctor Escobedo-López - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guillermo Sánchez-López - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Saulo Cruz-Sánchez - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Nelson-Daniel Gutiérrez-Campos - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Carlos-Alberto Gómez-Zamora - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Alejandro Terrones-Lozano - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2026 Héctor Escobedo-López et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
