TAILIEUCHUNG - Ebook Read book Atlas of pediatric infectious diseases (3/E): Part 2
(BQ) Part 2 book “Read book Atlas of pediatric infectious diseases” has contents: Human herpesvirus, human immunodeficiency virus infection, kawasaki disease, kingella kingae infections, legionella pneumophila infections, lyme disease, lymphatic filariasis, meningococcal infections, and other contents. | Leptospirosis 335 77 Epidemiology Leptospirosis Leptospirosis is an acute febrile disease with varied manifestations. The severity of disease ranges from asymptomatic or subclinical to self-limited systemic illness (approximately 90% of patients) to life-threatening illness with jaundice, renal failure (oliguric or nonoliguric), myocarditis, hemorrhage (particularly pul monary), and refractory shock. Clinical presentation may be monophasic or biphasic. Classically described biphasic leptospirosis has an acute septicemia phase, usually lasting 1 week, when Leptospira organisms are present in blood, followed by a second immune- mediated phase that does not respond to antibiotic therapy. Regardless of its severity, the acute phase is characterized by nonspecific symptoms, including fever, chills, headache, nausea, and vomiting, occasionally accompanied by rash or conjunctival suffusion. Distinct clinical findings include notable conjunctival suffusion without purulent discharge (30%– 99% of cases) and myalgia of the calf and lumbar regions (40%–100% of cases). Findings commonly associated with the immune- mediated phase include fever, aseptic menin gitis, and uveitis; between 5% and 10% of Leptospira-infected patients are estimated to experience severe illness. Severe manifestations include any combination of jaundice and renal dysfunction (Weil syndrome), pulmonary hemorrhage, cardiac arrhythmias, and circulatory collapse. The estimated casefatality rate from severe illness is 5% to 15%, although it can increase to greater than 50% in patients with pulmonary hemorrhage. Asymptomatic or subclinical infection with seroconversion is frequent, especially in settings of endemic infection. Leptospirosis is among the most globally important zoonoses, affecting people in resource-rich and resource-limited countries in urban and rural contexts. It has been estimated that approximately 868,000 people annually worldwide are currently infected (range, .
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