Man Fell Into a Canal, Then His Eyes Started Bleeding

An 18-year-old whose eyes started filling with blood was found to have contracted a dangerous bacterial infection after falling into a canal.

The patient went to Haaglanden Medisch Centrum, a hospital in The Hague, the Netherlands, after suffering from a 101.12 degree fever and vomiting for two days. He was found to have blood hemorrhaging in both eyes, as well as scleral icterus (the yellowing of the whites of his eyes) and a heart rate of 110 beats per minute.

Testing discovered that he had a severe form of leptospirosis, as described by doctors Emilie C. Rijnink and Prataap K. Chandie Shaw in a New England Journal of Medicine case study.

Leptospirosis, also known as Weil's disease, is spread via the urine of infected animals. The most common animals to carry the disease include cattle, pigs, horses, dogs, and rodents like rats and mice, the U.S. Centers for Disease Control and Prevention (CDC) explains. Doctors suspect that the patient may have contracted the bacterial infection when he fell into a canal three weeks prior to his hospital visit.

"A severe form of leptospirosis that manifests as fever, jaundice, renal failure [kidney failure], and hemorrhage was suspected on the basis of the patient's classic presentation (including the subconjunctival [eye] bleeding) and exposure to water with probable contamination by rodent urine," described Rijnink and Shaw in the case study.

Leptospirosis usually enters the human body via cuts, ingestion of contaminated liquids and foods, or contact with mucous membranes of the body in the mouth, nose and eyes. The Leptospira bacteria then spread via the bloodstream to all of the body's organs.

If untreated, the infection can cause liver and kidney damage. It can also lead to hemorrhages across the body, including the eyes and even sometimes the lungs. In rare cases, the infection may spread to the membranes of the brain, leading to meningitis.

There are around half a million cases reported yearly worldwide, and the overall risk of death is thought to be between 5 and 10 percent.

Treatment of the infection usually involves antibiotics such as doxycycline or penicillin.

In this case, the patient recovered swiftly, and his symptoms cleared up.

"The patient was discharged after a 1-week hospital stay. At follow-up 3 weeks later, his symptoms, subconjunctival hemorrhage, and liver and kidney injury had resolved," Rijnink and Shaw wrote.

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