In September 2013, leptospirosis was diagnosed in two Spanish travellers returning from Thailand. The first case walked in floodwater in the Phi Phi Islands in pouring rain: 20 days later he presented with fever and acute hepatitis. The second presented with fever and renal failure 17 days after visiting the islands. These cases remind clinicians to consider leptospirosis in febrile patients with a history of contact with flood or fresh water while travelling to tropical countries.
Calvo-Cano, A., Aldasoro, E., Ramírez, M. F., Martínez, M. J., Requena-Méndez, A., & Gascon, J. (2014). Two cases of laboratory-confirmed leptospirosis in travellers returning to Spain from Thailand, September 2013. Eurosurveillance, 19(2). https://doi.org/10.2807/1560-7917.ES2014.19.2.20675