Acute kidney injury and thrombocytopenic fever-consider the infrequent causes

Acute kidney injury (AKI), fever, hepatosplenomegaly, and thrombocytopenia are characteristics of Hantavirus infections and leptospirosis, both worldwide zoonoses. Although AKI is usually the result of tubulointerstitial nephritis, glomerular damage with significant albuminuria and hematuria may be noted in both entities. Although Hantavirus infections are endemic in Western Europe and the United States, leptospirosis is predominantly seen in parts of South America and Asia. We here report 3 cases of thrombocytopenic fever and AKI presenting within several months in Northern Germany with initially suspected Hantavirus infection. Serologic testing finally unraveled the diagnosis of leptospiral infection.