RESUMEN
OBJECTIVE: Leptospirosis is an endemic disease in tropical countries, where it is characterized by clinical polymorphism. We report four cases of leptospirosis diagnosed at the military hospital of Libreville (Gabon). CASE REPORTS: Four men aged 16 to 31-years-old, were admitted for febrile jaundice, with impaired general condition and pain. All lived in disadvantaged neighborhoods in the capital. In each case, the laboratory workups found hepatic cytolysis, renal failure, hyperleukocytosis, anemia, and an inflammatory state. Serology was negative for hepatitis B and C and for HIV, as was testing for malaria. The failure to respond to presumptive antimalarial treatment suggested leptospirosis, and the diagnosis was confirmed in every case by positive serologies with significant antibody titers. The course was quickly favorable under treatment by an appropriate antibiotic; liver and kidney function returned to normal within a few days. CONCLUSION: In tropical zones, the diagnosis of leptospirosis must be considered in all cases of febrile jaundice, especially when liver and kidney function are impaired.