Leptospirosis in childhood which presents with hypoalbuminemia and gallbladder hydrops: Report of three cases

Leptospirosis has a wide spectrum that changes from subclinical disease to well defined clinical syndromes. Here, in have been presented three children with leptospirosis having different clinical and laboratory features. Three children who were 14, 9 and 5 years old; respectively admitted to our center with different complaints. First case had high grade fever, jaundice, bilateral moderate pretibial edema, and gallbladder hydrops in upper abdominal ultrasonography. Second case had high grade fever and myalgia. Third case had abdominal pain, burning sensation while urinating and jaundice. Urine samples of all three children were examined under dark field microscopy by which, motile, spiral microorganisms can be distinguished. Serum samples of the cases were analyzed for leptospirosis with patoc-I strain using Microscopic Agglutination Test (MAT). All three cases had hypoalbuminemia, hyperglobulinemia and different levels of liver and renal involvement. As the clinical signs of leptospirosis are not generally typical, it results in delays in diagnosis and treatment. The detection of gallbladder hydrops, hypoalbuminemia, and hyperglobulinemia may be an inducing clue for the diagnosis of leptospirosis. Copyright © 2010 by Türkiye Klinikleri.