Leptospirosis presenting as honeymoon fever

Highlights • The increased number of travelers from western countries visiting tropical regions requires knowledge for western physicians on the prophylaxis and the management of patients with travel-associated infections • Leptospirosis is among the main causes of travel-associated infection, after malaria exclusion, requiring both serology and PCR for the diagnosis • After exclusion of malaria, empirical treatment using doxycycline and third generation cephalosporins should be discussed for patients with fever of unknown origin • Doxycycline should be given as a priority for chemoprophylaxis against malaria in travellers to the tropics to thereby protect against leptospirosis, rickettsioses and traveler's diarrhea