Leptospirosis and Jarisch–Herxheimer reaction: Table 1.

Although not commonly seen in Japan, the incidence of leptospirosis reported in 2014 was the highest in the past 6 years. It is important to consider leptospirosis among patients who traveled to Okinawa, Japan, and to keep in mind Jarisch–Herxheimer reaction when administering antimicrobial agents to patients with leptospirosis. A 59-year-old Japanese man with a history of hypertension presented with a complaint of fever and watery diarrhea. He climbed mountains, got lost accidentally and drunk 2 l of fresh water in the swamp in Okinawa, Japan 2 weeks prior to admission. Physical examinations showed blood pressure 129/89 mmHg, heart rate 112/min, respiratory rate 30/min, temperature of 38.5°C and oxygen saturation of 97% on room air. His bilateral palpebral conjunctivas were significantly injected with jaundice. The patient had tenderness to bilateral thighs …