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Pediatric presentations of leptospirosis
Sarala Rajajee1, Janani Shankar, Lata Dhattatri
1Kanchi Kamakoti Childs Trust Hospital, Nungambakkam, Chennai, India. saralarajaje@yahoocom
Indian Journal of Pediatrics
|November 27, 2002
Summary
Leptospirosis in children is often missed due to non-specific symptoms. Early suspicion is crucial for diagnosis and to prevent severe outcomes like myositis and meningitis.
Area of Science:
- Pediatrics
- Infectious Diseases
- Clinical Medicine
Background:
- Leptospirosis in children is frequently underdiagnosed because its symptoms are non-specific, except for severe cases like Weil's disease.
- Recognizing non-icteric forms of leptospirosis is challenging without a high index of clinical suspicion.
Purpose of the Study:
- To analyze the clinical profile, laboratory findings, and outcomes of leptospirosis in pediatric patients.
- To highlight the importance of suspecting leptospirosis, particularly its myositis and meningitis presentations, in children.
Main Methods:
- Children with suggestive symptoms (fever, myalgia, jaundice, etc.) were included.
- Clinical data, laboratory parameters, treatment response, and outcomes were analyzed.
- Diagnostic confirmation involved Dark field microscopy and serological tests (MAT, ELISA IgM).
Main Results:
- Fever (96%) and headache/myalgia (24%) were the most common symptoms in 139 diagnosed cases.
- Hepatomegaly (72%) and icterus (18%) were frequent signs; meningitis (7%) and shock (9%) were also observed.
- Overlapping infections, such as with Salmonella typhi or Dengue Hemorrhagic Fever, led to complications like myocarditis, shock, and ARDS.
Conclusions:
- Non-icteric leptospirosis presents non-specifically and can be easily missed.
- Myositis and meningitis are emphasized as key presentations of leptospirosis in children.
- Delayed diagnosis significantly increases mortality and morbidity in pediatric leptospirosis cases.