Severe acute renal failure in a child: a rare complication of anicteric leptospirosis

Silva, Paulo Sérgio Lucas da; Lipinski, Rubens Wolfe; Magalhães, Roberta; Romero, Eliete Caló

doi:10.1007/s00467-007-0547-6

Cited by 5 publications

(3 citation statements)

References 18 publications

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“…Our literature search only finds a few case reports of children with Weil’s disease or severe leptospirosis [ 6 – 9 ], and none of them was from Indonesia. The involvement of multisystem organs was only reported in the two cases from Samoa and Srilanka [ 6 , 9 ]; whereas in two other cases, no liver involvement was detected [ 7 , 8 ].…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2016

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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.

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Section: Discussionmentioning

confidence: 99%

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

et al. 2016

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“…The authors showed that both groups had similar baseline clinical characteristics, but patients who received prompt daily dialysis had lower mean blood urea (107±8.2 vs. 153± 12.4 mg/dl, P=0.0054) and a lower mortality rate (16.7% vs. 66.7%, P=0.01) [81]. In children, peritoneal dialysis, hemodialysis, and even hemofiltration have been reported [31,47,54,56,58]. In our opinion, the best dialysis is the earliest and most intensive dialysis available.…”

Section: Treatmentmentioning

confidence: 96%

The kidney in leptospirosis

Abdulkader

Silva

2008

Pediatr Nephrol

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Leptospirosis is a worldwide zoonosis. Typically, patients are young men, although children can be affected. In children, this disease causes mainly alterations of sensorium. Acute renal failure and jaundice (Weil's syndrome) are less common in children than in adults. The main renal histological findings are acute interstitial nephritis and acute tubular necrosis. Acute renal failure is characterized by hypokalemia and nonoliguria. Many factors are involved in its physiopathology: hypotension, hypovolemia, rhabdomyolysis, hyperbilirubinemia, and, primarily, the direct action of leptospiral proteins. Antibiotic administration (especially early administration) reduces length of hospitalization and leptospiruria. For children, even late antibiotic treatment has been shown to reduce the extent of acute renal failure and thrombocytopenia. Although the best method of dialysis is not yet established, early and intensive dialysis can decrease mortality. Mortality in patients with acute renal failure is approximately 15-20% in association with the presence of oliguria, higher levels of creatinine, and older age. Functional recovery is fast and complete; however, abnormal urinary concentration can persist.

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“…In addition to the present case, there are other published reports, caused by different serovars, involving cases of anicteric leptospiral renal failure without major hepatic involvement or hemorrhagic complications that experienced complete restoration of kidney function (12)(13)(14).…”

Section: Discussionmentioning

confidence: 54%

Acute Interstitial Nephritis due to Leptospira grippotyphosa in the Absence of Weil’s Disease

Schmidhauser

Curioni

Bernasconi

2013

Canadian Journal of Infectious Diseases and Medical Microbiolog

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Severe acute renal failure in a child: a rare complication of anicteric leptospirosis

Cited by 5 publications

References 18 publications

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

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

The kidney in leptospirosis

Acute Interstitial Nephritis due to Leptospira grippotyphosa in the Absence of Weil’s Disease

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