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Am. J. Trop. Med. Hyg., 76(5), 2007, pp. 886-887
Copyright © 2007 by The American Society of Tropical Medicine and Hygiene

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ACUTE PANCREATITIS IN FATAL ANICTERIC LEPTOSPIROSIS

ANNE SPICHLER, ETHEL SPICHLER, MARCELO MOOCK, JOSEPH M. VINETZ, AND JOHN A. D. LEAKE*
Universidade São Paulo, São Paulo, Brazil; Hospital Geral de Pedreira, São Paulo, Brazil; Universidade Estadual do Rio de Janeiro, Rio de Janeiro, Brazil; Division of Infectious Diseases, Department of Medicine, University of California, San Diego School of Medicine, La Jolla, California; Division of Infectious Diseases, Children’s Hospital, San Diego, California; Department of Pediatrics, University of California, San Diego, California

We report a fatal case of anicteric leptospirosis with pancreatitis (acute hyperglycemia and insulin requirement, elevated lipase and amylase levels), pulmonary infiltrates, and refractory shock. In disease-endemic areas, leptospirosis with pancreatitis should be considered in patients with fever and abdominal pain, and serum pancreatic enzymes, blood glucose, and serum electrolytes should be closely monitored.

Received June 9, 2006. Accepted for publication February 5, 2007.

Acknowledgments: The American Committee on Clinical Tropical Medicine and Travelers’ Health (ACCTMTH) assisted with publication expenses.

* Address correspondence to John A. D. Leake, Division of Infectious Diseases, Children’s Hospital and Health Center, 3020 Children’s Way, MC 5041, San Diego, CA 92123. E-mail: jleake{at}chsd.org

Authors’ addresses: Anne Spichler and Marcelo Moock, Pedreira Hospital, 175, 4th Floor Intensive Care Unit, Hospital, Rua João Francisco de Moura, Campo Grande, São Paulo, Brazil 04455-170. Ethel Spichler, Department of Internal Medicine, Universidade Estadual do Rio de Janeiro, R. Prof. Manoel de Abreu, 444, 4th Floor, Via Isabel, Rio de Janeiro, Brazil 20550-170. Joseph M. Vinetz, Division of Infectious Diseases, Department of Medicine, University of California, San Diego School of Medicine, 9500 Gillman Drive, La Jolla, CA 92093. John A. D. Leake, Division of Infectious Diseases, Children’s Hospital and Health Center, 3020 Children’s Way, MC 5041, San Diego, CA 92123, Department of Pediatrics, University of California, San Diego, CA 92093, E-mail: jleake{at}chsd.org.






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Copyright © 2007 by the American Society of Tropical Medicine and Hygiene.