Rat fever

nope. Never heard of it in medical school outside a single lecture in animal related disease

Nor did I treat any cases when I worked in Africa (probably because I worked in a  rural area, but also no floods when I worked in Liberia).

Of course, since every fever was given penicillin, I might have cured some cases that never had been diagnosed. But I never saw the liver involvement and severe syndrome either.

The disease is easily treated early with antibiotics; the bad news is that often it is fast, so you wade in water, and then after a few days get a fever (big deal) and then voila the complete syndrome and you die.

 But here in the Philippines, we get deaths after every typhoon, from people wading in ankle deep/knee deep water in the street.

Science Daily has an article about a newer treatment for the severe cases....

While rare in the United States, leptospirosis remains an important health threat for impoverished populations in developing countries, causing more than one million illnesses and 60,000 deaths annually..... 

 The reasons why leptospirosis causes life-threatening manifestations, such as pulmonary hemorrhage and acute kidney failure, have been poorly understood. ...

Patients who died from leptospirosis had a defect in the expression of the gene encoding an antimicrobial peptide, cathelicidin, which is capable of killing bacteria, the researchers found. In contrast, survivors were able to mount a vigorous response to the infection as exemplified by the expression of genes that encode cathelicidin as well as those that play a role in adaptive immunity such as antigen presentation and immunoglobulin production.

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