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Leptospirosis is a reemerging zoonosis of global importance. Outbreaks are related to agricultural environments and exposure to flooding, and it is primarily found in tropical countries. Although cases with typical presentation are relatively easy to diagnose and treat, atypical cases make it difficult to differentiate from other diseases, especially those patients with digestive symptoms who present to departments of gastroenterology. A 54-year old man was admitted to hospital for jaundice, vomiting and fatty liver. leptospirosis antibody test and polymerase chain reaction did not help us to make a definite diagnosis. However, based on the patient’s presentation, physical characteristics and the muscular biopsy, Weil’s syndrome was diagnosed. This is a reminder that leptospirosis may be found in a developed city of southern China. Clinical experience, disease characterizations, physical signs and biopsy should be applied as more efficient ways to recognize atypical cases of leptospirosis

A case report of severe atypical Weil’s syndrome in a department of gastroenterology