<?xml version="1.0" encoding="UTF-8"?> <!DOCTYPE article PUBLIC "-//NLM//DTD JATS (Z39.96) Journal Publishing DTD v1.2d1 20170631//EN" "JATS-journalpublishing1.dtd"> <ArticleSet> <Article> <Journal> <PublisherName>journal-jmsr</PublisherName> <JournalTitle>Journal of Medical and Surgical Research</JournalTitle> <PISSN>I</PISSN> <EISSN>S</EISSN> <Volume-Issue>edvsdf</Volume-Issue> <PartNumber/> <IssueTopic>Multidisciplinary</IssueTopic> <IssueLanguage>English</IssueLanguage> <Season>efrb</Season> <SpecialIssue>N</SpecialIssue> <SupplementaryIssue>N</SupplementaryIssue> <IssueOA>Y</IssueOA> <PubDate> <Year>-0001</Year> <Month>11</Month> <Day>30</Day> </PubDate> <ArticleType>JMSR Gastroenterology</ArticleType> <ArticleTitle>Manuscript JMSR 2025AZ</ArticleTitle> <SubTitle/> <ArticleLanguage>English</ArticleLanguage> <ArticleOA>Y</ArticleOA> <FirstPage>0</FirstPage> <LastPage>0</LastPage> <AuthorList> <Author> <FirstName>Adil</FirstName> <LastName>Zyani</LastName> <AuthorLanguage>English</AuthorLanguage> <Affiliation/> <CorrespondingAuthor>N</CorrespondingAuthor> <ORCID/> <FirstName>Rabii</FirstName> <LastName>ajana</LastName> <AuthorLanguage>English</AuthorLanguage> <Affiliation/> <CorrespondingAuthor>Y</CorrespondingAuthor> <ORCID/> <FirstName>Rajae</FirstName> <LastName>Alkouh</LastName> <AuthorLanguage>English</AuthorLanguage> <Affiliation/> <CorrespondingAuthor>Y</CorrespondingAuthor> <ORCID/> <FirstName>Essad</FirstName> <LastName>Ounci</LastName> <AuthorLanguage>English</AuthorLanguage> <Affiliation/> <CorrespondingAuthor>Y</CorrespondingAuthor> <ORCID/> <FirstName>Ihsane</FirstName> <LastName>Mellouki</LastName> <AuthorLanguage>English</AuthorLanguage> <Affiliation/> <CorrespondingAuthor>Y</CorrespondingAuthor> <ORCID/> <FirstName>Hicham</FirstName> <LastName>Sbai</LastName> <AuthorLanguage>English</AuthorLanguage> <Affiliation/> <CorrespondingAuthor>Y</CorrespondingAuthor> <ORCID/> <FirstName>Smael</FirstName> <LastName>Labib</LastName> <AuthorLanguage>English</AuthorLanguage> <Affiliation/> <CorrespondingAuthor>Y</CorrespondingAuthor> <ORCID/> </Author> </AuthorList> <DOI/> <Abstract>Background: Leptospirosis is a widespread zoonotic disease that presents significant diagnostic challenges, particularly during pregnancy where its symptoms may mimic conditions such as HELLP syndrome, acute fatty liver of pregnancy (AFLP), and sepsis. Early and accurate diagnosis is critical for optimal maternal and fetal outcomes, especially in resource-limited settings.Case Report: A 35-year-old primiparous woman in her 36th week of gestation presented with abdominal pain and hypertension. Initial suspicions of HELLP syndrome led to an emergency cesarean section. Postpartum, she developed seizures and jaundice, necessitating intensive care. Extensive investigations revealed elevated procalcitonin levels, which, although nonspecific, guided the diagnosis of leptospirosis when other etiologies were excluded. The diagnosis was confirmed by serological testing. Comprehensive management included supportive care, antibiotics, and hematoma drainage, resulting in full recovery. Conclusion: This case highlights the diagnostic complexity of leptospirosis in pregnancy and the importance of a high index of suspicion. Procalcitonin, while not definitive, can assist in guiding diagnostic efforts and assessing disease severity. A comprehensive, multidisciplinary approach is essential for timely diagnosis and effective management, particularly in settings with limited access to advanced diagnostic tools.</Abstract> <AbstractLanguage>English</AbstractLanguage> <Keywords>Leptospirosis, Peripartum jaundice, Acute fatty liver, hellp syndrome</Keywords> <URLs> <Abstract>https://journal-jmsr.net/ubijournal-v1copy/journals/abstract.php?article_id=15577&title=Manuscript JMSR 2025AZ</Abstract> </URLs> <References> <ReferencesarticleTitle>References</ReferencesarticleTitle> <ReferencesfirstPage>16</ReferencesfirstPage> <ReferenceslastPage>19</ReferenceslastPage> <References/> </References> </Journal> </Article> </ArticleSet>