The Turkish Journal of Pediatrics 2017 , Vol 59 , Num 6
Leptospirosis in a child with acute respiratory distress syndrome
Osman Yeşilbaş 1 ,Esra Şevketoğlu 1 ,Hasan Serdar Kıhtır 1 ,Nevin Hatipoğlu 2 ,Hamdi Murat Yıldırım 1 ,Mehmet Bedir Akyol 3 ,Nuray Aktay-Ayaz 4 ,İbrahim Gökçe 5
1 Departments of Pediatric Intensive Care Unit, Bakirkoy Dr. Sadi Konuk Research and Training Hospital, Istanbul, Turkey
2 Department of Pediatric Infectious Disease, Bakirkoy Dr. Sadi Konuk Research and Training Hospital, Istanbul, Turkey
3 Department of Pediatric Cardiology, Bakirkoy Dr. Sadi Konuk Research and Training Hospital, Istanbul, Turkey
4 Department of Pediatric Rheumatology, Kanuni Sultan Süleyman Research and Training Hospital, Istanbul, Turkey
5 Department of Pediatric Nephrology, Marmara University Medical Faculty Hospital, Istanbul, Turkey
DOI : 10.24953/turkjped.2017.06.011 Yeşilbaş O, Şevketoğlu E, Kıhtır HS, Hatipoğlu N, Yıldırım HM, Akyol MB, Aktay-Ayaz N, Gökçe İ. Leptospirosis in a child with acute respiratory distress syndrome. Turk J Pediatr 2017; 59: 688-692.

Leptospirosis is an infectious vasculitis, which can occur with different clinical features. While it is generally a subclinical and self-limited infection; kidney and liver dysfunction, pulmonary hemorrhage, thrombocytopenia, and cardiovascular collapse may occurr. A six-year-old boy presented with acute respiratory distress syndrome, shock, thrombocytopenia-associated multiple organ failure, and persistent high fever secondary to leptospirosis. Persistent high fever was resistant to intravenous immunoglobulin and pulse steroid therapy. He was successfully treated with plasmapheresis and hemofiltration with endotoxin-cytokine cleaning filter. In conclusion; leptospirosis may cause thrombocytopenia-associated multiple organ failure, persistent high fever, and acute respiratory distress syndrome. Plasmapheresis and hemofiltration should be considered in cases of severe leptospirosis with multiorgan failure. Keywords : acute respiratory distress syndrome, leptospirosis, persistent high fever, thrombocytopenia-associated multiple organ failure

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