Weil's disease as a cause of jaundice

Two patients are described with Weil's disease as a rare cause of jaundice. We discuss some features that can lead to early diagnosis. This concerns the apparently aspecific flu-like syndrome that precedes the icteric phase of the disease, as well as the typical pattern of liver function tests in the jaundiced patient: serum bilirubin is markedly elevated as compared with the liver enzymes. Another clue to the diagnosis can be obtained by enquiring not only about the patient's profession, but also about his leisure activities, since both patients acquired the disease in their leisure time.