Which statement about leptospirosis prognosis is true?

• A. Azotemia and thrombocytopenia are associated with poor prognosis
• B. Hyperbilirubinemia is never seen
• C. Hyperkalemia is always present
• D. Leptospirosis prognosis is not influenced by laboratory findings

Answer: (A)

In leptospirosis, prognosis tracks how severely the organs are affected, and lab abnormalities help gauge that severity. When the kidneys fail, shown by azotemia (elevated BUN/creatinine), outcomes worsen because renal failure is a major driver of death in severe disease. Thrombocytopenia indicates platelet consumption and bleeding risk, another sign of severe involvement that carries a poorer prognosis. Hyperbilirubinemia is common in Weil disease, reflecting hepatic involvement, so the idea that it is never seen is incorrect. Hyperkalemia is not a universal finding—renal failure can cause high potassium, but it’s not always present, and electrolyte disturbances can vary. Overall, prognosis in leptospirosis is indeed influenced by laboratory findings, making the presence of azotemia and thrombocytopenia a true indicator of worse outcome.