Leptospirosis is a zoonotic infection caused by spirochaete bacteria Leptospira. Rodents are common host species, but major reservoirs also occur in cattle, pigs and other mammals. Most people with leptospirosis have a mild and self-limiting illness, but severe disease occurs in up to 15% and can manifest with pulmonary haemorrhage, acute kidney injury and/or multiorgan failure. People with severe disease can deteriorate rapidly, but prompt intensive care unit support in well-resourced settings can result in excellent outcomes. Q fever is a zoonotic bacterial disease caused by Coxiella burnetii. Animal reservoirs include cattle, sheep and goats but feral mammals and native Australian marsupials may also carry the organism. Most acute Q fever infections are asymptomatic or mild and self-limiting, but respiratory, gastrointestinal and cutaneous symptoms can also occur. Acute Q fever may also present with severe disease necessitating intensive care unit support. The treatment of acute Q fever usually only requires a short course of oral antibiotics, and most people will recover without long term sequalae, but chronic Q fever can occur and may manifest as endocarditis, aortitis, hepatitis or osteomyelitis. The treatment of chronic Q fever is much more complex, requires prolonged antibiotics and the optimal management is poorly defined. This presentation will discuss the epidemiology, clinical manifestations, diagnosis, treatment and follow up of people with leptospirosis and Q fever.