TNF and leptospirosis: Leptospira disseminates via the bloodstream in the body without forming any skin lesions unlike other spirochetes and settles in renal tubules and peritubular capillaries because of a special affinity for them.1 Evidence shows that the cytokine storm with the release of IL-10, TNF-alpha occurs in severe leptospirosis when there is a high level of leptospiraemia.