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Tânia Mendo, Catarina Gouveia, Flora Candeias, João Neves, Maria João Brito

Unidade de Infecciologia, Área da Mulher, Criança e Adolescente, Hospital de Dona Estefânia, Centro Hospitalar de Lisboa Central, EPE, Lisboa

- Apresentado sob a forma de comunicação oral no 35th Annual Meeting of the European Society for Paediatric Infectious Diseases (ESPID) Madrid, Spain, May 23-27, 2017

Introduction: Leptospirosis is more prevalent in developing countries. In rural areas, hot and humid regions of tropical climate but not in Europe. The clinical course varies from self-limited or subclinical cases to potentially life-threatening forms.
Objectives: To characterize leptospirosis cases hospitalized in a Paediatric Infectious Unit in the last 10 years.
Methodology: A retrospective study between January 2006 and December 2016 was conducted. Demographic, complications data and outcome were analysed.
Results: A total of 18 hospitalizations with 61.1% in 2016, with a median age of 12 years. Most 11/18 resided in Lisbon near the river areas, 5/18 in rural areas, 7/18 had a recent travel history to Alentejo, Algarve, North of Africa and North America and 15/18 had been in contact with animals including dogs, cats, goats and sheep. The clinic presentation was fever (15), myalgia (10), rash (7) and headache (6). The diagnosis was made by urine specific PCR (72%), fresh urine microscopy (33.3%) and serum serology-MAT (11%). Complications occurred in 11/18 (61%) cases: hepatitis (4), renal failure (3), coagulopathy (2), hyperbilirrubinemia (2), hepatic failure (2), seizures (2), hemophagocytic syndrome (1), neuroretinitis (1), pancreatitis (1) and encephalitis (1). Three patients required intensive unit care. One patient needed liver transplantation and a patient with encephalitis died. The mean hospitalization was 15 days. All cases were reported to the Public Health Department.
Conclusion Leptospirosis is a notifiable disease that should be associated with major public health actions in the control of animal disease and in improving the social conditions of the population. The increased of the incidence in the last year and of the majority residing in the river areas of Greater Lisbon could be related to the increased constructions that are taking place in the city with possible entrainment and contamination of the waters.

Palavras Chave: Leptospirosis, emerging disease, Portugal