Leptospirosis in Differential Diagnosis of Septic Shock in Children

Abstract

Leptospirosis is one of the most common zoonotic infectious disease all over the world. The disease is caused by the spirochetes originated from Leptospira genus. Weil's disease, which is characterized by icterus, renal failure and disseminated hemorrhage, is seen in 510% of the patients and 515% are mortal. Two years and four months old female patient was admitted with fever, vomiting, confusion, tachypnea. Septic shock was determined and she had neurological, cardiovascular, hematological, renal and hepatic failure. As she has contact with untied animals and has a story of living in bad environmental conditions, leptospirosis was suspected. Leptospira IgM antibody was positive and leptospira were isolated in urine and blood cultures. Spirochetes were seen in the Giemsa stain and dark field examinations. All organ functions became normal except encephalopathy with supportive and medical therapy. Neurological symptoms and encephalopathy also became normal after two weeks. The patient was completely recovered. Leptospirosis should be thought, when a patient with environmental risk factors is admitted with shock, icterus and hemorrhagic diathesis in childhood. Early diagnosis and appropriate therapy are life saving. (J Pediatr Inf 2007; 1: 73-5)