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Introduction: Leptospirosis is a worldwide zoonosis. It is transmitted through the urine of infected animals. Currently, there is an increase of reports in many countries. In humans, it presents an ample clinical spectrum, which goes from an asymptomatic infection up to Weil syndrome, which is generally fatal. Clinical Case: A male, 6 years of age, who started with onset fever and jaundice, handled in private means, diagnosed as viral hepatitis “A” and was referred to an institutional hospital where hepatomegaly and splenomegaly were detected. His evolution was towards graveness and, therefore, he was referred to a third level hospital with reactive Hepatitis diagnosis and to rule out lymphoma. On admission, he presented liver and kidney failure, as well as metabolic acidosis and pulmonary haemorrhage that led to death 6 hours later. Confirmatory tests for hepatitis were negative; biopsies were taken post-mortem for Leptospira diagnosis, which were positive in liver and kidney. Conclusions: Leptospirosis is a disease that may be manifested in multiple ways. It is important the understanding of this disease by the physician to improve the diagnosis and, for general population, to avoid exposure. The examination of the epidemiological history of the patient is essential.