title: Severe acute renal failure in a child: a rare complication of anicteric leptospirosis.
abstract: 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.
authors.affiliation: Pediatric Intensive Care Unit, Department of Pediatrics, Hospital do Servidor Público Municipal, São Paulo, Brazil. psls.nat@terra.com.br
authors.forename: Paulo Sérgio Lucas
authors.initials: PS
authors.lastname: da Silva
authors.forename: Rubens Wolfe
authors.initials: RW
authors.lastname: Lipinski
authors.forename: Roberta Penha Paiva
authors.initials: RP
authors.lastname: Magalhães
authors.forename: Eliete Calo
authors.initials: EC
authors.lastname: Romero
mesh_terms: D058186:Acute Kidney Injury / Q000382:microbiology*; D000293:Adolescent; D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003402:Creatine Kinase / Q000097:blood; D006801:Humans; D007922:Leptospirosis / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D008297:Male; D051381:Rats; D012206:Rhabdomyolysis / Q000382:microbiology; D012720:Severity of Illness Index; D013921:Thrombocytopenia / Q000382:microbiology; D015047:Zoonoses / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents; D003402:Creatine Kinase