Case report: Weil’s disease with multiple organ failure in a child living in dengue endemic area

Abstract

BackgroundThere were few reports in the literature of Weil’s disease with multiple organ failures, especially in children living in dengue endemic areas.Case presentationA 12-year-old child was admitted to Tangerang district hospital with a provisional diagnosis of dengue infection. On the third day of hospitalization, dengue diagnostic tests were negative. As fever still remained and was followed by jaundice, decreasing hemoglobin, increasing bilirubin with abnormal value of liver enzymes; other causes of disease were investigated. Leptospirosis was confirmed by rapid IgM test (SD®) for leptospira; and micro-agglutination test which indicated Leptospira serogroup bataviae infection. The patient developed Weil’s disease during the course of illness. Renal function was back to normal on the 21st day of hospitalization, while hemoglobin and bilirubin returned to normal three weeks after discharged.ConclusionsOur report highlights the importance of considering leptospirosis as a differential diagnosis in children with acute febrile illness; even when the signs and symptoms for the more common diagnoses such as dengue or typhoid fever were pathognomonic. A normal leukocyte count with neutrophilia and negative dengue NS1, dengue IgM, and Salmonella typhi IgM on admission should raise suspicion of leptospirosis, and prompt diagnostic assays for leptospirosis should be conducted.Electronic supplementary materialThe online version of this article (doi:10.1186/s13104-016-2210-4) contains supplementary material, which is available to authorized users.

Leptospirosis in Indonesia: diagnostic challenges associated with atypical clinical manifestations and limited laboratory capacity

“…We know of no other recent studies reporting the incidence of leptospirosis from seven large cities across Indonesia. Previously published reports have been from Jakarta in 1993-1995 [14], Papua in 1997-2000 [14], Semarang in 1995-1996 and 2005-2009 [15][16][17], Tangerang in 2015 [18], and returning travelers from Sumatra and Bali in 2008 and 2013 [19,20]. Rates of acute leptospirosis in our study ranged from 0% in Denpasar to 8.9% in Semarang, likely reflecting country-wide variations in endemicity.…”

An Unusual Cause for Bowel Perforation- Leptospirosis

“…The most common manifestations of the severe disease are jaundice, renal failure and haemorrhage. However, it is a disease with varied clinical manifestations that can affect almost any organ in the body causing myocarditis, pancreatitis, acalculous cholecystitis, rhabdomyolysis, transverse myelitis, flaccid paraplegia, Guillain Barre syndrome, cerebral venous thrombosis, uveitis and renal failure [1][2][3][4][5][6][7][8][9][10]. Gastrointestinal manifestations have been described in leptospirosis in the form of bowel gangrene, pancreatitis, peritonitis, acalculous cholecystitis [1,2].…”

Leptospirosis, An Unusual Differential of Diffuse Alveolar Haemorrhage (DAH) in a Non-Tropical ITU- A Case Report

“…The animals that can transmit the disease include cattle, pigs, horses, dogs and wild animals such as raccoons. Theses animal may not exhibit the signs and symptoms of the disease but act as vectors for the disease 14 . The spirochaete enters the host by invading the abraded skin and mucous membranes.…”