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12 year old boy presented to pediatrician with history of fever vomiting and abdominal pain, two days back. Pediatrician was my old student and he contacted me yesterday as this boy did nt pass urine for almost 24 hours and his renal function deteriorating. He developed conjuctival bleed and his coagulation parameters abnormal. He considered possibility of leptospirosis and was put on injection crystalline penicillin and ceftriaxone yesterday itself. He was send to us  daybefore yesterday night.  The investigation results done from outside were Total count 30000,with neurtophilia  Hemoglobin 14 gm/ dl Platelet 1.5 lakh Liver function test Total bilirubin 0.9 mg/dl,direct 0.2mg , SGPT 60 iu,SGOT 46 iu,Total protein normal  Coagulation parameters INR 3 , APTT 60  Blood urea 90mg/dl , Creatinin 4.3 mg/dl ESR 26 mms /hour  Lepto igM was negative On arrival ,  he was conscious , Blood pressure normal and capillary refill time 3 sec.periphery warm. On arrival he pass