Volume 86, Issue 2
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



Although leptospirosis may be fatal in childhood, the experience of many clinicians working in disease-endemic 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 São Paulo during 2004–2006. 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 ( = 0.01), elevated serum bilirubin levels ( < 0.01), oliguria ( = 0.02), and elevated creatinine levels ( = 0.01) but not for thrombocytopenia or pulmonary involvement. The overall case-fatality rate was 27% (adult) versus 5% (pediatric) ( < 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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  1. Bharti AR, Nally JE, Ricaldi JN, Matthias MA, Diaz MM, Lovett MA, Levett PN, Gilman RH, Willig MR, Gotuzzo E, Vinetz JM, , 2003. Leptospirosis: a zoonotic disease of global importance. Lancet Infect Dis 3: 757771.[Crossref]
  2. McBride AJ, Athanazio DA, Reis MG, Ko AI, , 2005. Leptospirosis. Curr Opin Infect Dis 18: 376386.
  3. Levett PN, , 2001. Leptospirosis. Clin Microbiol Rev 14: 296326.
  4. Marotto PC, Marotto MS, Santos DL, Souza TN, Seguro AC, , 1997. Outcome of leptospirosis in children. Am J Trop Med Hyg 56: 307310.
  5. Rajajee S, Shankar J, Dhattatri L, , 2002. Pediatric presentations of leptospirosis. Indian J Pediatr 69: 851853.[Crossref]
  6. Karande S, Kulkarni H, Kulkarni M, De A, Varaiya A, , 2002. Leptospirosis in children in Mumbai slums. Indian J Pediatr 69: 855858.[Crossref]
  7. Silva HR, Tavares-Neto J, Bina JC, Meyer R, , 2003. Leptospiral infection and subclinical presentation among children in Salvador, Bahia [in Portuguese]. Rev Soc Bras Med Trop 36: 227233.[Crossref]
  8. Zaki SR, Shieh WJ, , 1996. Leptospirosis associated with outbreak of acute febrile illness and pulmonary haemorrhage, Nicaragua, 1995. The Epidemic Working Group at Ministry of Health in Nicaragua. Lancet 347: 535536.[Crossref]
  9. Gouveia EL, Metcalfe J, de Carvalho AL, Aires TS, Villasboas-Bisneto JC, Queirroz A, Santos AC, Salgado K, Reis MG, Ko AI, , 2008. Leptospirosis-associated severe pulmonary hemorrhagic syndrome, Salvador, Brazil. Emerg Infect Dis 14: 505508.[Crossref]
  10. Medeiros Fda R, Spichler A, Athanazio DA, , 2010. Leptospirosis-associated disturbances of blood vessels, lungs and hemostasis. Acta Trop 115: 155162.[Crossref]
  11. Spichler AS, Vilaca PJ, Athanazio DA, Albuquerque JO, Buzzar M, Castro B, Seguro A, Vinetz JM, , 2008. Predictors of lethality in severe leptospirosis in urban Brazil. Am J Trop Med Hyg 79: 911914.
  12. Spichler A, Athanazio D, Buzzar M, Castro B, Chapolla E, Seguro A, Vinetz JM, , 2007. Using death certificate reports to find severe leptospirosis cases, Brazil. Emerg Infect Dis 13: 15591561.[Crossref]
  13. Cruz ML, Andrade J, Pereira MM, , 1994. Leptospirosis in children in Rio do Janeiro [in Portuguese]. Rev Soc Bras Med Trop 27: 59.[Crossref]
  14. Lopes AA, Costa E, Costa YA, Sacramento E, de Oliveira Junior AR, Lopes MB, Lopes GB, , 2004. Comparative study of the in-hospital case-fatality rate of leptospirosis between pediatric and adult patients of different age groups. Rev Inst Med Trop Sao Paulo 46: 1924.[Crossref]

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  • Received : 12 May 2011
  • Accepted : 01 Oct 2011

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