title: Differences among children, adolescents and adults with severe leptospirosis: A comparative analysis.
abstract: Leptospirosis is a zoonosis of global importance caused by Leptospira interrogans. The aim of this study was to compare the data between children, adolescents and adults with leptospirosis. This is a retrospective study including a total of 373 consecutive patients with leptospirosis, admitted to tertiary hospitals in Northeast of Brazil, from May 1985 to August 2010. The patients were divided into two groups (age ≤21 years and >21 years). The adults were 304 (81.5%) of the population, with a mean ge of 41 ± 13 (range 22-84) years. The pediatric group was 16 ± 3 (range 9-21) years. Signs and symptoms where similar between the groups, excepting arrhythmia, which was more frequent in adults and vomiting, more common in children (16% vs. 0%, P = 0.04 and 65% vs. 79%, P = 0.02), respectively. Adult group presented with higher serum urea (137 vs. 97 mg/dl, P = 0.002) and creatinine (4.3 vs. 3.0 mg/dl, P = 0.007). Acute kidney injury (AKI) was observed in 80%, mainly in adults (83% vs. 70% P < 0.005). Adults required renal replacement therapy more frequently than children (38% vs. 11%, P < 0.0001). Mortality was higher in adults (14.8% vs. 2.8%, P = 0.005) and in adults with AKI (93% vs. 7%, P < 0.05). There are important differences between the adults and children with leptospirosis. AKI was more frequent in adults and it was associated with increased mortality.
authors.affiliation: Department of Internal Medicine, School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil.
authors.forename: E F
authors.initials: EF
authors.lastname: Daher
authors.affiliation: Department of Internal Medicine, School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil.
authors.forename: A P F
authors.initials: AP
authors.lastname: Vieira
authors.affiliation: Department of Internal Medicine, School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil.
authors.forename: C N
authors.initials: CN
authors.lastname: Jacinto
authors.affiliation: Department of Nephrology, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
authors.forename: R S A
authors.initials: RS
authors.lastname: Lima
authors.affiliation: Department of Internal Medicine, School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil.
authors.forename: M M V
authors.initials: MM
authors.lastname: Girão
authors.affiliation: Department of Internal Medicine, School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil.
authors.forename: A T B M
authors.initials: AT
authors.lastname: Fernandes
authors.affiliation: Department of Community Health, School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil ; Department of Infectious Diseases, São José Infectious Diseases Hospital, Fortaleza, Ceará, Brazil.
authors.forename: R J P
authors.initials: RJ
authors.lastname: Neto
authors.affiliation: Department of Internal Medicine, School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil ; Department of Medicine, Health Sciences Center, University of Fortaleza, Fortaleza, Ceará, Brazil.
authors.forename: G B
authors.initials: GB
authors.lastname: Silva
keywords: Acute kidney injury; adults; children; leptospirosis; mortality