A Rare Case of Leptospirosis-Induced Liver Injury in an Urban Setting

Abstract

and sheep. Rodents are the most important reservoirs, and once infected, they harbor and shed the pathogen through their urine. Human infection occurs when animal urine or contaminated water or soil comes in contact with mucous membranes, conjunctivae, or skin lacerations [2].On average, clinical manifestations of leptospirosis start after a 10-day incubation period. The infection varies from mild and self-limited illness in most cases, to a severe and potentially fatal disease. Symptoms are non-specific and include a wide range of different system involvement including gastrointestinal, respiratory, musculoskeletal, hepatic, and genitourinary systems. Case PresentationA 50-year-old African American man presented to the emergency department of a New York City hospital with a chief compliant of bilateral leg weakness. Patient said that one week prior to presentation, he had sudden onset of abdominal cramps, nausea, multiple episodes of non-bloody, non-bilious vomiting, and watery diarrhea, which all lasted for a few days. Patient attributed his gastrointestinal symptoms to street food he ate prior to the onset of his illness. His condition deteriorated, and he developed subjective fevers, chills, and severe muscle aches, mainly in his legs. Patient's muscle pain progressively worsened, to the point where he felt his legs became weak, causing difficulty walking, so he decided to seek medical attention. He denied any recent travel, sick contacts, alcohol use, use of over the