The authors present the high-resolution CT findings of a patient with diffuse pulmonary hemorrhage due to leptospirosis. The main finding consisted of extensive ground-glass opacities super imposed on mild interlobular septal thickening, resulting in the appearance termed "crazy- paving". The patient died and the necropsy showed extensive haemorrhage filling the airspace and blood infiltrating the interlobular sep- ta. The correlation between the high-resolution CT and pathological findings is emphasised.