Leptospirosis is a worldwide zoonosis with the highest incidence in subtropical and tropical areas. It is a very rare disease in Europe, especially in children and adolescents. However, exposures through outdoor activities, predominantly water sports, are currently increasing in Europe. The clinical manifestation of leptospirosis is very diverse. A biphasic progression of the disease is often observed, beginning with flu-like symptoms and usually followed by a further mild progress with nonspecific symptoms. In rare cases, the process of the disease is severe and can lead to multiple organ failure with the clinical symptoms of sepsis. Weil‘s disease, a triad of renal failure, jaundice and splenomegaly, is a particular clinical manifestation of a fulminant disease. In case of fulminant pneumonia with clinical manifestations of Weil‘s disease, leptospirosis should also be considered as a differential diagnosis. A detailed (travel) history may be helpful.