Intensive Care Unit, Centre Hospitalier Territorial, Noumea, New Caledonia.
PLoS Negl Trop Dis. 2013 Sep 26;7(9):e2436. doi: 10.1371/journal.pntd.0002436. eCollection 2013.
In endemic areas, leptospirosis is more common and more severe in adults compared with children. Reasons to explain this discrepancy remain unclear and limited data focusing on adolescents are available. The objective of the study was to describe disease spectrum and outcome differences in children and adolescents admitted for leptospirosis in a large at-risk population.
Clinical and laboratory data were obtained on hospitalized cases in New Caledonia from 2006 to 2012.
Data of 60 patients <18 years of age (25 children under 14 and 35 adolescents aged 14 to 17) with confirmed leptospirosis were analyzed. Compared with children, adolescents presented more often with classic features of Weil disease (p = 0.02), combining hepatic and renal involvement with or without pulmonary participation. Jarisch-Herxheimer reactions were observed more often among adolescents (p<0.01). The overall case fatality rate was low (1 adolescent versus 0 children).
Severe leptospirosis in adolescents may be more likely to show adults' characteristics compared with children. Further studies are required to explore age-dependant host factors, including puberty-related physiological changes.
在流行地区，与儿童相比，成人的钩端螺旋体病更为常见且更为严重。造成这种差异的原因尚不清楚，目前针对青少年的相关数据有限。本研究的目的是描述在高危人群中，因钩端螺旋体病住院的儿童和青少年患者的疾病谱和预后差异。
本研究收集了 2006 年至 2012 年新喀里多尼亚住院钩端螺旋体病患者的临床和实验室数据。
共分析了 60 名<18 岁（25 名<14 岁的儿童和 35 名 14-17 岁的青少年）确诊为钩端螺旋体病的患者的数据。与儿童相比，青少年更常出现经典的 Weil 病特征（p=0.02），表现为肝肾功能损害，伴或不伴有肺部受累。青少年更常出现 Jarisch-Herxheimer 反应（p<0.01）。总病死率较低（1 例青少年和 0 例儿童）。
与儿童相比，青少年严重的钩端螺旋体病可能更倾向于表现出成人的特征。需要进一步研究探索与年龄相关的宿主因素，包括青春期相关的生理变化。
