A Case Report of Autoimmune Haemolytic Anaemia in Leptospirosis, a Rare Presentation

Leptospirosis is a zoonotic illness caused by pathogenic spirochetes of the genus Leptospira, which causes diverse clinical manifestations and complications. Infection is biphasic, with a bacteraemic phase and an immune-mediated phase. A small number of patients will develop multiorgan failure. Transient thrombocytopenia is the most common haematological manifestation, while immune-mediated haemolytic anaemia is a very rare manifestation observed in humans. A 22-year-old previously healthy male presented with high-grade fever, body aches, and a background history of exposure to muddy water. He was managed for leptospirosis complicated with multiorgan failure. He developed a gradual drop of haemoglobin during the immune phase, clinical features and investigations were in favour of cold-type autoimmune haemolytic anaemia (AIHA), highlighting the importance of considering the occurrence and identifying the type of AIHA among patients with leptospirosis with multiorgan involvement.