Question

A 25-year-old sewage worker presents with fever lasting a week, followed by sudden weakness. He has scleral congestion, jaundice, and oliguria. Lab findings show raised bilirubin. What is the most likely diagnosis?

• A. Brucellosis
• B. Weil's disease
• C. Enteric fever
• D. DHF

Hint:

Sewage worker with fever, jaundice, renal failure, and conjunctival suffusion = Weil's disease.

Answer 1

The Correct Option is B

Concept: Weil's disease is the severe icteric form of leptospirosis. It is commonly seen in people exposed to contaminated water, sewage, or rat urine. Important features include fever, jaundice, renal failure, conjunctival suffusion, and oliguria.

Step 1: Identify the occupational risk.
The patient is a sewage worker. This increases exposure to contaminated water and rat urine, which are common sources of: \[ \textit{Leptospira interrogans} \]

Step 2: Identify the clinical triad.
The important findings are: \[ \text{Fever + jaundice + oliguria} \] Along with scleral congestion, this is very typical of severe leptospirosis.

Step 3: Name the severe form.
The severe icteric form of leptospirosis is called: \[ \text{Weil's disease} \] Therefore, the most likely diagnosis is Weil's disease.