A Dual Diagnosis in the Puerperium: Severe Endometritis Complicated by Leptospirosis-Induced Weil's Syndrome

Abstract

Endometritis is defined as the inflammation of the endometrium and myometrium. Social factors can predispose to concomitant tropical infections, and diseases such as leptospirosis can have overlapping symptoms. We present the case of a 19-year-old female who had an urgent cesarean section, had a poor clinical course with jaundice, acute kidney injury, and coagulopathy requiring a second surgical time, and underwent an urgent hysterectomy for severe and irreversible endometritis. Additionally, leptospirosis-induced Weil’s syndrome was confirmed by serology (positive IgM) due to the presence of systemic alterations that could not be explained by a gynecologic condition alone. Endometritis has identifiable risk factors, and a typical antibiotic regimen is usually sufficient to prevent complications. However, severe cases can still occur despite treatment. This case highlights the diagnostic challenge of differentiating severe sepsis due to obstetric syndromes and zoonotic diseases such as leptospirosis, which can mimic gynecologic diseases and delay diagnosis and treatment. Analyzing each case is crucial to identifying unusual pathologies in pregnant patients and preventing adverse outcomes.