A thirteen-year-old girl from Dezfoul, Iran was referred to our hospital with a history of eight days of high fever, headache, odynophagia, diffuse abdominal and body pain especially limb pain. She then developed conjunctival erythema, transient maculopapular rash on the trunk and also diplopia. No obvious or specific point was shown in the history. In the lab studies, she had very high sedimentation rate (ESR), bandemia and leukocytosis and thrombocytosis with negative results for an array of infectious diseases. Before making a vasculitis diagnosis a microscopic agglutination test for leptospira and then PCR test in blood and stool were requested and revealed to be positive for leptospira. She responded to doxycycline and remained well after one year of follow-up. Leptospirosis should be considered in differential diagnosis of vasculitic syndromes in Iran even for patients from seemingly non-enzootic areas.Keywords: Leptospirosis; Iran; Vasculitis; Child Implication for health policy/practice/research/medical education: Leptospirosis can be manifested like a systemic illness especially collagen vascular diseases and should be considered even for cases with low prevalence of disease in Iran.