Pediatric Fulminant Leptospirosis Complicated by Pericardial Tamponade, Macrophage Activation Syndrome and Sclerosing Cholangitis

Year 2016, Volume: 33 Issue: 5, 578 - 580, 01.09.2016

Osman Yeşilbaş Hasan Serdar Kıhtır Hamdi Murat Yıldırım Nevin Hatipoğlu Esra Şevketoğlu

Abstract

Background: Leptospirosis is a zoonotic infectious
disease caused by pathogenic spirochetes of the genus
Leptospira. Although it is usually asymptomatic and
self-limited, severe potentially fatal illness accompanied
by multi-organ failure may occur.
Case Report: Here we report an unusual case of severe
leptospirosis successfully treated with continuous
venovenous hemofiltration (CVVHF) and therapeutic
plasma exchange (TPE). The patient presented with
pericardial tamponade, renal failure and macrophage
activation syndrome, and later suffered prolonged jaundice
and sclerosing cholangitis during hospitalization in
the pediatric intensive care unit (PICU). To the best of
our knowledge, sclerosing cholangitis due to leptospirosis
has not been reported in the literature.
Conclusion: Leptospirosis should be kept in mind in
the differential diagnosis of sepsis and septic shock
with fever, thrombocytopenia, jaundice and renal failure.
TPE and CVVHF should start early after the diagnosis
of leptospirosis with multiorgan failure

Keywords

Leptospirosis, macrophage activation syndrome, pericardial tamponade, sclerosing cholangitis

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