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A study of twelve sporadic cases revealed leptospirosis to be an acute, self-limited, diphasic illness with a low incidence of jaundice or significant renal damage. The first stage manifestations were compatible with the septicemic state which is known to occur during the first five to seven days, but the clinical picture in the second stage appeared to be the consequence of the body's immunologic response. It is proposed that this phase be referred to as the "immune" stage rather than as the "icteric" or "toxic" stage. It was impossible to correlate the different clinical disease patterns with the leptospiral serotypes identified in these cases. For this reason the use of special names as synonyms for infections with certain species is not justified. The diagnosis of leptospirosis should be considered in any patient with an acute illness characterized by headache, myalgia, fever, chills and conjunctival suffusion, and in any patient in whom "aseptic meningitis" develops following an acute febrile illness of five to seven days' duration. The greatest danger of infection in man is from contact with stagnant water to which wild or domesticated animals have access, but infection may result from direct contact with the urine of infected animals as well.

A case of leptospirosis due toL icterohemorrhagiae in a 56-year-old man is reported. The infection most likely resulted from immersion in a contaminated urban river, and presented as afebrile jaundice. Severe hepatorenal decompensation developed, but neither myalgia nor conjunctival suffusion occurred. Complete recovery occurred with nonspecific therapy.