Introduction: Leptospirosis and typhoid fever are water borne diseases. These diseases present as acute undifferentiated fever and often can be challenging to clinicians in the developing world due to limited resources. Case Presentation: A 15-year-old Malay girl presented a week after swimming in a waterfall with fever, vomiting and lethargy. Her condition deteriorated into septic shock and respiratory distress requiring mechanical ventilation. Her blood,
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