Which one of the following is not a feature of leptospirosis -
The clinical expression of infection by Leptospira , which is related to diverse focal organ dysfunction, includes subclinical infection, an undifferentiated febrile illness, and Weil's disease--the most severe form. Classic Weil's disease is suggested by elevated levels of blood urea nitrogen and serum creatinine in conjunction with mixed conjugated and unconjugated hyperbilirubinemia with aminotransferase elevation to less than five times the upper limit of normal. In all forms of leptospirosis (not just Weil's disease), a variety of abnormalities can occur. Elevation of the noncardiac isoform of creatine kinase may indicate skeletal muscle damage. Hematologic abnormalities are variable but common: leukocytosis (typical in severe disease), leukopenia, hemolytic anemia, mild to moderate anemia, and thrombocytopenia . (Harrison's Principles of internal medicine, 20th edition, page 1395)
Aminotransferase elevation to less than five times
Elevated creatinine phosphokinase
Hepatorenal syndrome
Thrombocytopenia
Infection