[Isolated febrile intra-alveolar hemorrhage detected in leptospirosis]

We report observation of a patient of 25 years who presented with an isolated intra-alveolar haemorrhage occurring during the course of an illness suggestive of septicaemia. Considering the epidemiological context of inhalation of water from the River Saone, the diagnosis of acute leptospirosis ictero-haemorrhagica was considered and was confirmed by serological tests. Several publications draw attention to the pulmonary manifestations of acute leptospirosis which remains rare and poorly understood. Pulmonary disease is characterised not by an infectious alveolitis but by the occurrence of intra-alveolar haemorrhage whose pathogenetic mechanism remains under discussion.