{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T04:51:09Z","timestamp":1784868669271,"version":"3.55.0"},"reference-count":14,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2012,2,1]]},"abstract":"<jats:p>Although leptospirosis may be fatal in childhood, the experience of many clinicians working in disease-endemic areas is that classic Weil's disease and death are less common among pediatric patients. The aim of the study was to ascertain disease spectrum and outcome differences in severe pediatric and adult leptospirosis in a large at-risk population. Epidemiologic, clinical, and laboratory data were obtained on hospitalized cases from S\u00e3o Paulo during 2004\u20132006. A total of 42 case-patients &lt; 18 years of age and 328 case-patients \u2265 18 years of age were tested during the study. Compared with children, adults had higher rates of jaundice (<jats:italic>P<\/jats:italic> = 0.01), elevated serum bilirubin levels (<jats:italic>P<\/jats:italic> &lt; 0.01), oliguria (<jats:italic>P<\/jats:italic> = 0.02), and elevated creatinine levels (<jats:italic>P<\/jats:italic> = 0.01) but not for thrombocytopenia or pulmonary involvement. The overall case-fatality rate was 27% (adult) versus 5% (pediatric) (<jats:italic>P<\/jats:italic> &lt; 0.01). Severe pediatric leptospirosis may be less likely to show all classic features of Weil's disease and may be less fatal than in adults.<\/jats:p>","DOI":"10.4269\/ajtmh.2012.11-0308","type":"journal-article","created":{"date-parts":[[2012,2,6]],"date-time":"2012-02-06T21:50:37Z","timestamp":1328565037000},"page":"306-308","source":"Crossref","is-referenced-by-count":18,"title":["Comparative Analysis of Severe Pediatric and Adult Leptospirosis in S\u00e3o Paulo, Brazil"],"prefix":"10.4269","volume":"86","author":[{"given":"Anne","family":"Spichler","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel A.","family":"Athanazio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro","family":"Vila\u00e7a","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Seguro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Vinetz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John A. D.","family":"Leake","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"R1","series-title":"Lancet Infect Dis","first-page":"757","article-title":"Leptospirosis: a zoonotic disease of global importance","volume":"3","author":"Bharti","year":"2003"},{"key":"R2","series-title":"18","first-page":"376","article-title":"Leptospirosis. Curr Opin Infect Dis","author":"McBride","year":"2005"},{"key":"R3","series-title":"14","first-page":"296","article-title":"Leptospirosis. 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The Epidemic Working Group at Ministry of Health in Nicaragua","volume":"347","author":"Zaki","year":"1996"},{"key":"R9","series-title":"Emerg Infect Dis","first-page":"505","article-title":"Leptospirosis-associated severe pulmonary hemorrhagic syndrome, Salvador, Brazil","volume":"14","author":"Gouveia","year":"2008"},{"key":"R10","series-title":"Acta Trop","first-page":"155","article-title":"Leptospirosis-associated disturbances of blood vessels, lungs and hemostasis","volume":"115","author":"Medeiros Fda","year":"2010"},{"key":"R11","series-title":"Am J Trop Med Hyg","first-page":"911","article-title":"Predictors of lethality in severe leptospirosis in urban Brazil","volume":"79","author":"Spichler","year":"2008"},{"key":"R12","series-title":"Emerg Infect Dis","first-page":"1559","article-title":"Using death certificate reports to find severe leptospirosis cases, Brazil","volume":"13","author":"Spichler","year":"2007"},{"key":"R13","series-title":"Rev Soc Bras Med Trop","first-page":"5","article-title":"Leptospirosis in children in Rio do Janeiro [in Portuguese]","volume":"27","author":"Cruz","year":"1994"},{"key":"R14","series-title":"Rev Inst Med Trop Sao Paulo","first-page":"19","article-title":"Comparative study of the in-hospital case-fatality rate of leptospirosis between pediatric and adult patients of different age groups","volume":"46","author":"Lopes","year":"2004"}],"container-title":["The American Society of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/86\/2\/article-p306.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/86\/2\/article-p306.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/86\/2\/article-p306.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,7]],"date-time":"2024-08-07T18:05:35Z","timestamp":1723053935000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/86\/2\/article-p306.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,2,1]]},"references-count":14,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.2012.11-0308","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,2,1]]}}}