Leptospirosis presents in a biphasic manner: an early leptospiraemic phase and a late immune phase. In its severe form, it presents with multi-organ failure, also known as Weil's disease. Stevens-Johnson syndrome (SJS) is an autoimmune hypersensitive reaction leading to diffuse fluid filled vesicle formation with detachment of skin and mucous membrane. Though SJS is triggered by different infections and drugs, its association with leptospirosis is not frequently reported. Here we present such a case.

Primary Sjogren’s syndrome is an autoimmune disorder primarily involving the exocrine glands but it can have a varied presentation. It can also present without classically described sicca symptoms. One-third of the patients experience extra-glandular involvement in the form of nonspecific arthralgia, myalgia, arthritis, parenchymal involvement of renal parenchyma, lung, and rarely nerves. Renal involvement in primary Sjogren’s can present with type 1 renal tubular acidosis (RTA) and is associated with a normal anion gap and hypokalemia. We, hereby, report a case of primary Sjogren’s syndrome presenting with type 1 RTA with hypokalemic quadriparesis as the first presenting feature.

The COVID-19 pandemic has taught us the emphasis of personal hygiene which was long being ignored. Measures such as hand sanitizer which were predominantly used in health-care facilities in the past have seen recent surge in its usage everywhere. The availability of hand sanitizer in almost all the settings in this pandemic including the household has heralded a new step in personal hygiene. People across the world are using hand sanitizer everywhere. As much is known about its beneficial effect in preventing the spread of pathogens, its injudicious use has resulted in discovering its adverse effect if misused. We hereby present a case where the patient with Type 1 diabetes mellitus presented with hand sanitizer ingestion. This case highlights the unwanted effects and lethality of hand sanitizer if used in an unintended manner and hence alert us for its judicious use in the pandemic.