Desmopressin and Dexamethasone Adjunctive Treatment for Leptospirosis

Inclusion Criteria: * adult patients (\> 14 years) with suspected severe leptospirosis * patients who presented with acute fever (oral temperature more than 38.00 C for \<15 days) in the absence of an obvious focus of infection * In the opinion of the attending physician might have pulmonary hemorrhage (i.e. history of hemoptysis, and/ or bilateral nodular or air space infiltration). Exclusion Criteria: * pregnant or breastfeeding * those with history of bleeding disorder * those who had underlying diseases such as chronic liver disease, diabetes mellitus * those who received diuretic or glucocorticoid