Aygün Fatma Deniz, Avar-Aydın Pınar Özge, Çokuğraş Haluk, Camcıoğlu Yıldız
Division of Pediatric Infectious Diseases, Istanbul University Cerrahpasa Faculty of Medicine, Istanbul, Turkey.
Clinical Immunology and Allergy, Department of Pediatrics, Istanbul University Cerrahpasa Faculty of Medicine, Istanbul, Turkey.
Turk J Pediatr. 2016;58(2):212-215. doi: 10.24953/turkjped.2016.02.015.
Leptospirosis is a prevalent zoonotic disease. Human infection usually occurs through exposure to environmental sources. Clinical course of leptospirosis is variable. We presented five patients, aged between 4-14 years, having a history of contact with rodents and symptoms 7-10 days after contact. The first three cases were relatives and had contact with dead rats after applying insecticides to bakery across from their house. The first case diagnosed as isolated meningitis, others as flu-like illness. The fourth case had a contact history with a rat inundate in the canalization and diagnosed as acute hepatitis. The last case, living in a village with poor sanitation, developed secondary hemophagocytic syndrome. ELISA was performed for diagnosis. High dose penicillin and additional immunosuppressive drugs for the last case were used. All cases showed recovery within 10 days. Leptospirosis should be considered in any patient presenting with an abrupt onset or prolonged fever, myalgia, headache and jaundice.
钩端螺旋体病是一种常见的人畜共患病。人类感染通常通过接触环境源发生。钩端螺旋体病的临床病程多变。我们报告了5例年龄在4至14岁之间的患者，他们有接触啮齿动物的病史，且在接触后7至10天出现症状。前三例是亲属，在其房屋对面的面包店喷洒杀虫剂后接触了死鼠。第一例被诊断为孤立性脑膜炎，其他病例被诊断为流感样疾病。第四例有接触被水淹没在下水道中的老鼠的病史，被诊断为急性肝炎。最后一例生活在卫生条件差的村庄，发展为继发性噬血细胞综合征。采用酶联免疫吸附测定（ELISA）进行诊断。对最后一例使用了高剂量青霉素和额外的免疫抑制药物。所有病例均在10天内康复。对于任何出现突发或持续发热、肌痛、头痛和黄疸的患者，都应考虑钩端螺旋体病。
