Leptospirosis and coinfections leading to fatal multiple organ and system failure

Coinfection with leptospirosis and other infectious agents pose major challenges in medical practice, often due to difficulties in isolating these agents, symptoms overlap, and lack of specific investigation protocols in areas with emerging and re-emerging diseases. Consequently, knowledge regarding these coinfections and their impact on clinical outcomes are limited. A previously healthy 33-year-old woman, with no history of chronic or malignance diseases, was admitted with febrile icteric illness, pulmonary hemorrhage, acute kidney injury, thrombocytopenia, and shock. Leptospirosis, COVID-19, human rhinovirus, and dengue in the acute phase were clinically and pathologically diagnosed. Multiple coinfections can rapidly lead to multiple organ and system failure, often resulting in a fatal outcome.