Pediatric presentations of leptospirosis

Rajajee, Sarala; Shankar, Janani; Dhattatri, Lata

doi:10.1007/bf02723704

Cited by 21 publications

(14 citation statements)

References 11 publications

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“…Such severe myositis is well known with leptospirosis, bacterial myositis, influenza virus infection, but not well known with the dengue infection [3,8]. The first three patients experienced severe skeletal muscle weakness and respiratory muscle involvement along with very high blood creatine phosphokinase levels during the first week of the illness.…”

Section: Discussionmentioning

confidence: 94%

Acute dengue virus myositis: A report of seven patients of varying clinical severity including two cases with severe fulminant myositis

Paliwal

Garg

Juyal

et al. 2011

Journal of the Neurological Sciences

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Section: Discussionmentioning

confidence: 94%

Acute dengue virus myositis: A report of seven patients of varying clinical severity including two cases with severe fulminant myositis

Paliwal

Garg

Juyal

et al. 2011

Journal of the Neurological Sciences

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“…3 However, the incidence and disease spectrum of pediatric and adult leptospirosis are not well-described in most areas, and precise information on the frequency and types of severe manifestations in sizeable pediatric populations is limited. [4][5][6] Experienced clinicians in disease-endemic areas commonly believe that leptospirosis produces milder symptoms among children. [5][6][7] In adult case series, approximately 5-10% of human infections indicate severe disease, including the classic Weil's syndrome triad of acute renal failure, jaundice, and hemorrhage (with or without severe pulmonary hemorrhage syndrome [SPHS]) and case-fatality rates ranging from 5-15% (Weil's) to !…”

Section: Introductionmentioning

confidence: 99%

Comparative Analysis of Severe Pediatric and Adult Leptospirosis in São Paulo, Brazil

Spichler¹,

Athanazio²,

Vilaça³

et al. 2012

The American Journal of Tropical Medicine and Hygiene

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Abstract. Although leptospirosis may be fatal in childhood, the experience of many clinicians working in diseaseendemic areas is that classic Weil's disease and death are less common among pediatric patients. The aim of the study was to ascertain disease spectrum and outcome differences in severe pediatric and adult leptospirosis in a large at-risk population. Epidemiologic, clinical, and laboratory data were obtained on hospitalized cases from Sã o Paulo during [2004][2005][2006]. A total of 42 case-patients < 18 years of age and 328 case-patients ! 18 years of age were tested during the study. Compared with children, adults had higher rates of jaundice (P = 0.01), elevated serum bilirubin levels (P < 0.01), oliguria (P = 0.02), and elevated creatinine levels (P = 0.01) but not for thrombocytopenia or pulmonary involvement. The overall case-fatality rate was 27% (adult) versus 5% (pediatric) (P < 0.01). Severe pediatric leptospirosis may be less likely to show all classic features of Weil's disease and may be less fatal than in adults.

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“…Jaundice was present in only 18% of cases with renal failure. Hepatomegaly was observed in 72%, 9% of children presented with shock and 7% had meningitis [19]. Beside of this we consider that it should be kept in mind the observation of Silva HR et al (2003) that leptospiral infection in children is underestimated, because it is asymptomatic or presents as a cold syndrome simile [20].…”

Section: Discussionmentioning

confidence: 98%

“…The prevalence of splenomegaly, jaundice, oliguria, abdominal pain, diarrhea and arrhythmia was significantly higher in adults. In the study of Rajajee et al (2002) among 139 children with leptospirosis, the commonest symptoms were fever (96%), headache and myalgia (24%). Jaundice was present in only 18% of cases with renal failure.…”

Section: Discussionmentioning

confidence: 99%

Comparative Analysis of Pediatric and Adult Leptospirosis in Pleven Region, Bulgaria

Gancheva¹

2017

SJCM

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Abstract:Leptospirosis is worldwide re-emerging zoonosis with protean clinical manifestations. The more common mild, anicteric form is characterized by nonspecific symptoms such as fever, headache, chills, myalgia, nausea and abdominal pain. The severe, potentially fatal form (Weil's disease) typically presenting as triad of jaundice, acute renal failure (ARF), and hemorrhage is estimated to occur in 5-15% of all human infections with mortality rate up to 40%. Elder age is one of poor prognostic factors in leptospirosis. There are few studies about leptospirosis in children and no one comparative study of pediatric and adult leptospirosis in regions with temperate climate. Our aims were to describe retrospectively the disease spectrum and outcome differences in children and adults with leptospirosis over a period of 41 years and to compare severity in different age groups. The study material comprised the data from 105 consecutive leptospirosis cases from Central Northern Bulgaria treated in Clinic of Infectious Diseases at University Hospital -Pleven (1976-2016) (95 male, age 37±18 years, lethal outcome in 12.38%), followed by comparative analysis of group of children (age ≤17-years-old; N 1 =13) versus group of adults (age ≥18 years-old; N 2 =92). Results: Fever (100%), hepatomegaly (92%), conjunctival suffusions (88%), myalgia (87%), nausea and vomiting (84%), shivering (79%), splenomegaly (74%), headache (65%), jaundice (64%), oliguria (58%), tachycardia (55%), hypotension (50%), abdominal pain (41%), and hemorrhagic diathesis (37%) were the most characteristic manifestations in whole series. Only headache and meningitis had had a significantly higher prevalence in the group of children. Leucocytosis, blood urea nitrogen, serum creatinine, serum bilirubin, aminotransferases, gamma glutamyl tranferase (GGT) and serum amylase levels were significantly higher in group of adults. Potassium level, total protein and albumins were significantly lower in the same group. The distribution of cases in whole series according to severity was as follows: mild cases -27, moderate -44 cases and severe -34 cases. In group of children seven mild and six moderate cases had been observed versus 20 mild, 38 moderate and 34 severe cases in the group of adults. All thirteen deceased patients were adults. We concluded that in Pleven region, leptospirosis in children usually is mild and anicteric. The leptospiral meningitis is not unusual manifestation for pediatric leptospirosis. The major factors leading to death in adults with leptospirosis were lung edema and brain edema due to severe ARF.

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Pediatric presentations of leptospirosis

Abstract: Presentation of non-icteric forms of Leptospirosis are often non-specific and may be missed unless there is a high index of suspicion. This study emphasizes the myositis and meningitis forms of leptospirosis. Delayed diagnosis leads to increased mortality and morbidity.

Cited by 21 publications

References 11 publications

Acute dengue virus myositis: A report of seven patients of varying clinical severity including two cases with severe fulminant myositis

Acute dengue virus myositis: A report of seven patients of varying clinical severity including two cases with severe fulminant myositis

Comparative Analysis of Severe Pediatric and Adult Leptospirosis in São Paulo, Brazil

Comparative Analysis of Pediatric and Adult Leptospirosis in Pleven Region, Bulgaria

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