A male individual, aged 54, exhibited symptoms including fever, rigors, myalgia, dry cough, and dyspnea. Ten days prior, he provided a description of an ailment resembling an upper respiratory infection. The recorded body temperature measured 38.2°C. The physical examination findings included the presence of scleral icterus, jaundice, conjunctival hyperemia, extensive ecchymoses at multiple locations on the body, an antecubital hematoma, bilateral basal rales, hepatomegaly, and splenomegaly. The White Blood Cell Count (WBC) was measured to be 1.100/mm3, Hemoglobin (Hgb) level was found to be 11.8 g/dL, the platelet count was seen to be 10.000/mm3, the Erythrocyte Sedimentation Rate (ESR) was determined to be 68 mm/h, and C-Reactive Protein (CRP) concentration was measured at 84 U/L. The serum biochemistry analysis revealed elevated levels of liver enzymes and bilirubin. The chest radiograph exhibited bilateral basal interstitial linear opacities and the presence of pleural effusions. The confirmation of leptospirosis diagnosis was achieved through the utilization of both serologic tests and a real-time Polymerase Chain Reaction (PCR) assay. The patient received oral doxycycline at a dosage of 100 mg twice daily and intravenous ceftriaxone at a dosage of 1 gram daily for a duration of one week. After undergoing treatment, the patient experienced a complete remission of symptoms and had a smooth recovery without any complications. The prevalence of pulmonary involvement in individuals diagnosed with leptospirosis has been reported to reach up to 70%. The presence of pulmonary symptoms as the primary manifestation of the atypical clinical spectrum might pose a considerable diagnostic problem for doctors. This is because the illness can appear with a wide range of symptoms affecting many organs throughout the body. The potential consequences of delayed identification and treatment of leptospirosis might be severe. The objective of this review is to elucidate the clinical characteristics of pulmonary leptospirosis. Another objective is to present an analysis of evaluation scores in order to obtain a precise final diagnosis. [ABSTRACT FROM AUTHOR]