[Severe course of an infection with Leptospira grippotyphosa (author's transl)]

In a 22 years old female patient severe jaundice, renal failure and myocarditis developed 3 days after the onset of fever and other uncharacteristic symptoms. In dark-field microscopy leptospires were found. Inspite of high-dose penicillin therapy exitus letalis occurred in myocardial and circulatory failure, due to a severe interstitial myocarditis. Leptospira grippotyphosa could be proven serologically as the causative bacterium. It is pointed out, that leptospirosis inspite of their rare occurrence should be included in the differential diagnosis of infections of undetermined origin, especially if jaundice develops. The demonstration of leptospira in blood, cerebro-spinal fluid or urin by means of darkfield microscopy may quickly support the diagnosis. Since the course of severe leptospirosis can be influenced significantly only up to the 4th day after the onset, high-dose penicillin G or tetracycline therapy should be initiated already when the clinical suspicion is present.