Acute hepatitis A infection: a predisposing factor for severe leptospirosis

Leptospirosis is a rare and potentially fatal infection that requires a high index of suspicion for timely diagnosis and treatment. Diagnosis of leptospirosis can be particularly difficult in context of coexistent viral hepatitis. We present a case of Weil's syndrome, in which a concurrent resolving Hepatitis A virus infection was concomitantly diagnosed. Assessment of epidemiologic risk factors and serial serology testing were key in making this diagnosis. The immunologic consequence of the coexistence of these two infections is also discussed. It is likely that hepatitis A infection predisposed our patient's leptospirosis infection to progress to Weil's syndrome.