Workplace- and Residence-Associated Leptospirosis: A Case Report and Review of Current Literature

Leptospirosis is a zoonotic infection most commonly occurring in tropical regions through contact with water or soil contaminated with animal urine. In New York, approximately one to three cases occur annually, the majority occurring through workplace exposure to animal reservoirs. In cases of the more severe presentation of leptospirosis, Weil's disease, it is important to identify the infection promptly to allow for early antibiotic initiation as well as early initiation of daily dialysis in cases in which it is necessary. We present a case of Weil's disease in a 64-year-old male with presumed exposure through his combined workplace and residential environment. The resolution of symptoms occurred through a combination of hemodialysis, doxycycline, and meropenem antibiotic treatment. We also discuss the barriers to diagnosis, including the non-specific presentation of leptospirosis, the limitation of access to testing centers, and the limitations to antibody testing within the first week of symptom presentation due to low antibody levels.