Outcome of Leptospirosis in Children

Marotto, Paulo C. F.; Marotto, Marcia Schettini; Santos, Denise Langanke dos; Souza, Tâmara Newman Lobato; Seguro, Antônio Carlos

doi:10.4269/ajtmh.1997.56.307

Cited by 51 publications

(47 citation statements)

References 14 publications

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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 Society 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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Section: Introductionmentioning

confidence: 99%

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

Spichler¹,

Athanazio²,

Vilaça³

et al. 2012

The American Society of Tropical Medicine and Hygiene

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“…3,5,8,10,12,13 In a hospital in Sao Paulo, Brazil, the Instituto de Infectologia Emílio Ribas, the mortality rate was 18% among adult patients admitted in the 1980s with severe Weil's disease and 2% among children admitted in the 1990s. 3,14 Everard and others showed a trend for the mortality that increased with age. 5 On the other hand, Dupont and others did not find age to be an independent factor associated with mortality.…”

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confidence: 96%

Risk factors for death and changing patterns in leptospirosis acute renal failure.

Daher¹,

Zanetta²,

Cavalcante³

et al. 1999

The American Journal of Tropical Medicine and Hygiene

110

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Abstract. The risk factors for death and changes in clinical patterns in leptospirosis (Weil's disease) have not been well studied. We retrospectively studied 110 patients with Weil's disease hospitalized in Brazil between 1985 and 1996. Univariate statistical analysis showed that nonsurvivors were older than survivors, and had higher frequency of oliguria, cardiac arrhythmia, dyspnea, and pulmonary rales. Logistic regression showed that the only independent factor associated with death was oliguria (odds ratio [OR] ϭ 8.98). The presence of arthralgia (OR ϭ 4.71), dehydration (OR ϭ 6.26), dyspnea (OR ϭ 17.7), and pulmonary rales (OR ϭ 9.91) increased after 1994. These data suggest that in Weil's disease the clinical patterns have changed and the presence of oliguria is a risk factor for death.

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“…Em São Paulo, no Instituto de Infectologia Emilio Ribas, 43 crianças foram hospitalizadas com a doença no período entre janeiro de 1989 e dezembro de 1995, e 88% tiveram contato com água contaminada 12 . Em 152 municípios de São Paulo foram estudados 2.969 casos de leptospirose, no período entre janeiro de 1989 e dezembro de 1994, verificando com maior freqüência coeficientes entre 2 e 10 casos/100.000 habitantes 15 .…”

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Leptospirose humana no município de Belo Horizonte, Minas Gerais, Brasil: uma abordagem geográfica

Figueiredo

Mourão

Oliveira

et al. 2001

Rev. Soc. Bras. Med. Trop.

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Resumo Uma análise retrospectiva da leptospirose humana no município de Belo Horizonte em 1995 foi realizada usando recursos de geoprocessamento.Trinta casos suspeitos e 19 casos confirmados foram localizados na área. A predominância de casos confirmados foi registrada nas regiões norte, nordeste e oeste (68,4 ± 13%). Nas áreas de favelas e bolsões de pobreza foram identificados os principais focos da doença, 73,7 ± 12% dos casos confirmados e 26,7 ± 12% dos casos suspeitos. Na periferia, onde ocorreu um aumento populacional, localizaram-se 95 ± 6% dos casos confirmados, sendo o local com maior carência de infraestrutura básica. Na distribuição espacial dos principais cursos d'água do município, observou-se que 50 ± 14% dos casos suspeitos e 42 ± 14% dos casos confirmados estavam localizados nas áreas com maior concentração de redes fluviais. Casos suspeitos (83,3 ± 10%) e confirmados (79 ± 11%) ocorreram em partes altimétricas mais baixas da cidade (750 a 1.000m) e 78 ± 12% dos indivíduos tiveram contato com água e / ou animais contaminados. Palavras-chaves: Leptospirose. Reação de soroaglutinação microscópica. Geoprocessamento.Abstract A retrospective study on human leptospirosis, was done in Belo Horizonte in 1995, using geographic processing resources. Thirty suspected and 19 confirmed cases of leptospirosis were mapped in the area. The majority of confirmed cases (68.4 ± 13%) were located in North, Northeast and West of the city. The main foci of disease were found in slums and other poor areas: 73.7 ± 12% of the confirmed cases and 26.7 ± 12% of suspected cases. Ninety-five percent ± 6% of the confirmed cases were found in the outskirts of the city where there was a population increase and inadequate infrastructure. It was observed that 50 ± 14% of the suspected cases and 42 ± 14% of the confirmed cases were found in areas of high concentration of water resources. Suspected (83.3 ± 10%) and confirmed cases (79 ± 11%) occurred in lower altitude areas of the city (750 to 1,000m) and 78 ± 12% of the individuals had been in contact with contaminated water and/or animals.

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Outcome of Leptospirosis in Children

Cited by 51 publications

References 14 publications

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

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

Risk factors for death and changing patterns in leptospirosis acute renal failure.

Leptospirose humana no município de Belo Horizonte, Minas Gerais, Brasil: uma abordagem geográfica

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