A 14-year-old male patient was admitted with fever, vomiting, muscular pain, mainly in the lower limbs, oliguria and oedema. The presence of rats in the vicinity of the home was reported. Laboratory tests on admission revealed severely compromised renal function and increased phosphokinase creatine and thrombocytopenia. Although the patient presented an atypical course without jaundice or meningeal involvement, early dialytic treatment was administered concomitant with empiric antibiotic therapy for leptospirosis. The probable infected serogroup by serology was Autumnalis. This atypical case illustrates that, in the presence of fever, renal failure, rhabdomyolysis and thrombocytopenia, leptospirosis should be considered, even in the absence of jaundice or meningitis, especially if there is a history of contact with carrier animals.
This is a preview of subscription content, log in to check access.
Buy single article
Instant unlimited access to the full article PDF.
Price includes VAT for USA
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
This is the net price. Taxes to be calculated in checkout.
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 3:757–771
Levett PN (2001) Leptospirosis. Clin Microbiol Rev 14:296–326
Coursin DB, Updike SJ, Maki DG (2000) Massive rhabdomyolysis and multiple organ dysfunction syndrome caused by leptospirosis. Intensive Care Med 26:808–812
Visith S, Kearkiat P (2005) Nephropathy in leptospirosis. J Postgrad Med 51:184–188
Abdulkader RC (1997) Acute renal failure in leptospirosis. Ren Fail 19:191–198
Peces R (2003) Acute renal failure in severe leptospirosis. Nephrol Dial Transplant 18:1235–1236
Erdinc FS, Koruk ST, Hatipoglu CA, Kinikli S, Demiroz AP (2006) Three cases of anicteric leptospirosis from Turkey: mild to severe complications. J Infect 52:45–48
Atasoyu EM, Turhan V, Unver S, Evrenkaya TR, Yildirim S (2005) A case of leptospirosis presenting with end-stage renal failure. Nephrol Dial Transplant 20:2290–2292
Turhan V, Atasoyu EM, Solmazgul E, Evrenkaya R, Cavuslu S (2005) Anicteric leptospirosis and renal involvement. Ren Fail 27:491–492
Tappero JW, Ashford DA, Perkins BA (2000) Leptospira species (leptospirosis). In: Principles and practice of infectious diseases, 5th edn. McGraw-Hill, New York, pp 2495–2501
de Souza AL, Sztajnbok J, Marques SR, Seguro AC (2006) Leptospirosis-induced meningitis and acute renal failure in a 19-month-old male child. J Med Microbiol 55:795–797
Romero EC, Bernardo CCM, Yasuda PH (2003) Human leptospirosis: a twenty-nine-year serological study in São Paulo, Brazil. Rev Inst Med Trop Sao Paulo 45:245–248
Vinetz JM, Glass GE, Flexner CE, Mueller P, Kaslow DC (1996) Sporadic urban leptospirosis. Ann Intern Med 125:794–798
Ko AI, Galvao Reis M, Ribeiro Dourado CM, Johnson WD Jr, Riley LW (1999) Urban epidemic of severe leptospirosis in Brazil. Salvador Leptospirosis Study Group. Lancet 354:820–825
Morgan J, Bornstein SL, Karpati AM, Bruce M, Bolin CA, Austin CC, Woods CW, Lingappa J, Langkop C, Davis B, Graham DR (2002) Outbreak of leptospirosis among triathlon participants and community residents in Springfield, Illinois, 1998. Clin Infect Dis 34:1593–1599
Haake DA, Dundoo M, Cader R, Kubak BM, Hartskeerl RA, Sejvar JJ, Ashford DA (2002) Leptospirosis, water sports, and chemoprophylaxis. Clin Infect Dis 34:40–43
St John MA, King S, Bullen SE, Cherian J, Levett PN (2000) Leptospirosis occurring in two children after fresh water immersion. West Indian Med J 49:340–343
Kobayashi Y (2005) Human leptospirosis: management and prognosis. J Postgrad Med 51:201–204
Levett PN (2003) Usefulness of serologic analysis as a predictor of the infecting serovar in patients with severe leptospirosis. Clin Infect Dis 36:447–452
Yang CW, Wu MS, Pan MJ (2001) Leptospirosis renal disease. Nephrol Dial Transplant 16:73–77
About this article
Cite this article
da Silva, P.S.L., Lipinski, R.W., Magalhães, R.P.P. et al. Severe acute renal failure in a child: a rare complication of anicteric leptospirosis. Pediatr Nephrol 22, 1971–1974 (2007). https://doi.org/10.1007/s00467-007-0547-6
- Intensive care unit
- Leptospirosis and renal failure