Severe acute renal failure in a child: a rare complication of anicteric leptospirosis

  • 109 Accesses

  • 5 Citations


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.

Access options

Buy single article

Instant unlimited access to the full article PDF.

US$ 39.95

Price includes VAT for USA

Subscribe to journal

Immediate online access to all issues from 2019. Subscription will auto renew annually.

US$ 199

This is the net price. Taxes to be calculated in checkout.


  1. 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 3:757–771

  2. 2.

    Levett PN (2001) Leptospirosis. Clin Microbiol Rev 14:296–326

  3. 3.

    Coursin DB, Updike SJ, Maki DG (2000) Massive rhabdomyolysis and multiple organ dysfunction syndrome caused by leptospirosis. Intensive Care Med 26:808–812

  4. 4.

    Visith S, Kearkiat P (2005) Nephropathy in leptospirosis. J Postgrad Med 51:184–188

  5. 5.

    Abdulkader RC (1997) Acute renal failure in leptospirosis. Ren Fail 19:191–198

  6. 6.

    Peces R (2003) Acute renal failure in severe leptospirosis. Nephrol Dial Transplant 18:1235–1236

  7. 7.

    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

  8. 8.

    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

  9. 9.

    Turhan V, Atasoyu EM, Solmazgul E, Evrenkaya R, Cavuslu S (2005) Anicteric leptospirosis and renal involvement. Ren Fail 27:491–492

  10. 10.

    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

  11. 11.

    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

  12. 12.

    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

  13. 13.

    Vinetz JM, Glass GE, Flexner CE, Mueller P, Kaslow DC (1996) Sporadic urban leptospirosis. Ann Intern Med 125:794–798

  14. 14.

    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

  15. 15.

    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

  16. 16.

    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

  17. 17.

    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

  18. 18.

    Kobayashi Y (2005) Human leptospirosis: management and prognosis. J Postgrad Med 51:201–204

  19. 19.

    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

  20. 20.

    Yang CW, Wu MS, Pan MJ (2001) Leptospirosis renal disease. Nephrol Dial Transplant 16:73–77

Download references

Author information

Correspondence to Paulo Sérgio Lucas da Silva.

Rights and permissions

Reprints and Permissions

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).

Download citation


  • Child
  • Intensive care unit
  • Leptospirosis and renal failure