Author/Presenter: Mikala B. Anderson DO
Resident, University of Texas Medical Branch, Pediatrics
Contributing Authors/Faculty
Mentors: Diana
Nguyen DO, Natalie Williams-Bouyer PhD, Ping Ren PhD, and Elizabeth
Rodriguez-Lien MD
Affiliations: University of Texas Medical Branch, Galveston, TX
POSTER ABSTRACT (View Poster PDF)
Background: Leptospirosis is caused by a
spirochete of the genus Leptospira,
an atypical zoonotic bacteria spread through urine of infected animals.1-3
Conjunctival suffusion without purulent discharge is a reliable distinguishing
feature of Leptospirosis when trying to distinguish between this disease and
similar diseases such as Rickettsial diseases.
Case Presentation: We discuss the case of a 12-year-old male with fever, rash,
pancytopenia, and myalgias who progressed to also having conjunctival injection
in the setting of living in a rural area. After work-up, a diagnosis of
Leptospirosis was made. He recovered with a course of doxycycline.
Discussion: Leptospirosis is caused by an atypical zoonotic bacteria (spirochete) spread through urine of infected asymptomatic animals such as cattle, pigs, horses, dogs, rodents, and other wild animals via skin or mucous membranes. Signs and symptoms include high fever, headache, chills, myalgias, emesis, jaundice, non-productive cough, abdominal pain, diarrhea, and rash. Conjunctival suffusion is a very reliable distinguishing feature from other infectious processes. Routine lab work is often non-specific but can have leukopenia with left shift and thrombocytopenia, hyponatremia, mild/moderate increase in liver enzymes, and urinalysis positive for proteinuria, pyuria, granular casts. Severe cases can lead to alveolar hemorrhage, ARDS, and pulmonary edema. Mild to moderate cases of Leptospirosis can be treated with doxycycline or azithromycin
References:
1.
American
Academy of Pediatrics. [Leptospirosis.] In Kimberlin DW, Brady MT, Jackson MA,
Long SS, eds. Red Book: 2018 Report of
the Committee on Infectious Diseases. 31th ed. Elk Grove
Village, IL: American Academy of Pediatrics; 2018:[510-513]
2.
Leptospirosis
| CDC. Centers for Disease Control and Prevention.
https://www.cdc.gov/leptospirosis/index.html.