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(a) unremarkable CXR on initial presentation; (b) CXR upon re-presentation with developing interstitial opacities.
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Chest x-ray was unremarkable (Fig. 1a). CXR showed development of interstitial opacities (Fig. 1b).
Patient covered in mud following participation in mud-run in Hawaii.
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Two days into the patient's admission to the tertiary hospital, his family recalled an important clue - they showed the medical team a digital photograph of the patient covered in mud that he had sent approximately two weeks prior to illness onset [Fig. 2].
Patient returning to active duty in US Navy following recovery from leptospirosis pulmonary hemorrhage syndrome.
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Following a three to five month process of medical clearance, the patient was able to return to active duty for the US Navy (Fig. 3).