A case of severe leptospirosis complicated with massive rhabdomyolysis and acute kidney injury: a case report

• Published in: Journal of medical case reports Vol. 19; no. 1; pp. 316 - 7
• Main Authors: Badri, Milad, Sheikhdavoodi, Negar, Nikkhahi, Farhad, Eslahi, Aida Vafae, Karanis, Panagiotis
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 04.07.2025; BioMed Central; BMC
• Subjects: Acute kidney injury; Acute Kidney Injury - etiology; Acute Kidney Injury - microbiology; Acute Kidney Injury - therapy; Adult; Anti-Bacterial Agents - therapeutic use; Care and treatment; Case Report; Emerging communicable disease; Enzyme-linked immunosorbent assay; Enzymes; Exercise; Fluid Therapy; Health aspects; Humans; Iran; Leptospirosis; Leptospirosis - complications; Leptospirosis - diagnosis; Leptospirosis - drug therapy; Leptospirosis - therapy; Male; Oxytetracycline; Physical fitness; Renal Dialysis; Rhabdomyolysis; Rhabdomyolysis - etiology; Rhabdomyolysis - microbiology; Rhabdomyolysis - therapy; Treatment Outcome; Waterborne infections; World health; Zoonoses; Iran; Leptospirosis; Emerging communicable disease; Case report; Rhabdomyolysis; Acute kidney injury
• DOI: 10.1186/s13256-025-05378-w
• ISSN: 1752-1947

Leptospirosis is a reemerging waterborne zoonotic infection with a significant global health importance. The manifestations are ranged from mild febrile illness to severe conditions, including Weil's disease and rhabdomyolysis-induced acute kidney injury. Here we report a case of a 27-year-old Iranian male patient with a history of mountain climbing who developed severe leptospirosis. The patient presented massive rhabdomyolysis, acute kidney injury, and respiratory distress, initially suspected to be related to his physical activity. The leptospirosis infection was confirmed using an enzyme-linked immunosorbent assay. Despite hydration and broad-spectrum antibiotic therapy, the patient's condition demanded intensive care and hemodialysis. Finally, the patient recovered completely, underscoring the critical need for timely diagnosis and intervention in leptospirosis cases. To date, there have been no reports of leptospirosis-associated rhabdomyolysis in Iran. Additionally, cases of rhabdomyolysis caused by leptospirosis are rare worldwide. This is report reveals the reemergence of leptospirosis, particularly in environments conducive to the survival of Leptospira bacteria, and the significance of awareness and preventive measures, especially for susceptible populations.