We are upgrading the repository! A content freeze is in effect until December 6, 2024. New submissions or changes to existing items will not be allowed during this period. All content already published will remain publicly available for searching and downloading. Updates will be posted in the Website Upgrade 2024 FAQ in the sidebar Help menu. Reach out to escholarship@umassmed.edu with any questions.
Authors
Libraty, Daniel H.Myint, Khin S. A.
Murray, Clinton K.
Gibbons, Robert V.
Mammen, Mammen P.
Endy, Timothy P.
Li, Wenjun
Vaughn, David W.
Nisalak, Ananda
Kalayanarooj, Siripen
Hospenthal, Duane R.
Green, Sharone
Rothman, Alan L.
Ennis, Francis A.
UMass Chan Affiliations
Department of Medicine, Division of Preventive and Behavioral MedicineDepartment of Medicine, Division of Infectious Diseases and Immunology
Center for Infectious Disease and Vaccine Research
Document Type
Journal ArticlePublication Date
2007-12-28
Metadata
Show full item recordAbstract
BACKGROUND: Leptospirosis is an emerging zoonosis that is often under-recognized in children and commonly confused with dengue in tropical settings. An enhanced ability to distinguish leptospirosis from dengue in children would guide clinicians and public health personnel in the appropriate use of limited healthcare resources. METHODOLOGY/PRINCIPAL FINDINGS: We conducted a prospective, hospital-based, study of children with acute febrile illnesses and dengue in Thailand. Among the children without dengue, we identified those with leptospirosis using anti-leptospira IgM and microscopic agglutination titers in paired acute and convalescent blood samples. We then performed a case-control comparison of symptoms, signs, and clinical laboratory values between children with leptospirosis and dengue. In a semi-rural region of Thailand, leptospirosis accounted for 19% of the non-dengue acute febrile illnesses among children presenting during the rainy season. None of the children with leptospirosis were correctly diagnosed at the time of hospital discharge, and one third (33%) were erroneously diagnosed as dengue or scrub typhus. A predictive model to distinguish pediatric leptospirosis from dengue was generated using three variables: the absolute neutrophil count, plasma albumin, and aspartate aminotransferase levels in the first 72 hours of illness. CONCLUSIONS/SIGNIFICANCE: Unrecognized leptospirosis can be a significant cause of "dengue-like" febrile illness in children. Increased awareness of pediatric leptospirosis, and an enhanced ability to discriminate between leptospirosis and dengue early in illness, will help guide the appropriate use of healthcare resources in often resource-limited settings.Source
PLoS Negl Trop Dis. 2007 Dec 26;1(3):e111. Link to article on publisher's siteDOI
10.1371/journal.pntd.0000111Permanent Link to this Item
http://hdl.handle.net/20.500.14038/38475PubMed ID
18160980Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1371/journal.pntd.0000111