Tohoku J. Exp. Med., 2003, 201 (1)

Case Report

Report of Three Children with Leptospirosis in
Rural Area of the East of Turkey

MUHAMMED GÜZEL KURTOGLU, OGUZ TUNCER,1 HAMZA BOZKURT, HÜSEYIN ÇAKSEN,
MUSTAFA BERKTAS, EBUBEKIR CEYLAN2 and ERCAN KIRIMI1

Department of Microbiology, 1Department of Pediatrics, Yuzuncu Yil University School of Medicine, Van, Turkey, 2Van Health Services Vocational College, Yuzuncu Yil University, Van, Turkey

Leptospirosis is a systemic infection usually producing fever with hepatorenal involvement, meningoencephalitis, and hemorrhage. In this article, we present three children between 10 and 13 years of age with leptospirosis. The purpose of this paper is to emphasize that leptospirosis is a problem in our country with farmers/cattle and that leptospirosis should be considered in certain ill children. The main symptoms were headache, fever, fatigue, abdominal pain and unconsciousness. Two patients had hepatic and renal involvement. The other had hepatic, pulmonary and probably pericardial involvement. In all children spirochetes were demonstrated in blood and urine smears by dark-field microscopy and they were also isolated from urine and blood cultures by using Flecher medium. All patients were treated with penicillin; however, one subsequently required additional antibiotics due to Klebsiella pneumoniae septicemia. While one patient was discharged in a good health, the others were taken to their home by parents without completing treatment. In conclusion, we would like to emphasize that leptospirosis is still a public health problem in our region (Eastern Turkey) in where the majority of population are farmers and raise domestic animals such as cattle in rural areas. Additionally, leptospirosis should be considered in children admitted with headache, unconsciousness, fever and abdominal pain.

keywords —— leptospirosis; child; spleen; abscess; brain; Turkey

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Tohoku J. Exp. Med., 2003, 201, 55-60

Address for reprints: Oguz Tuncer, M.D., Yuzuncu Yil University, Faculty of Medicine, Department of Pediatrics, Van, Turkey.

e-mail: oguztuncer76@lycos.com