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首页> 外文期刊>The American Journal of Tropical Medicine and Hygiene >Comparative analysis of severe pediatric and adult leptospirosis in S?o Paulo, Brazil
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Comparative analysis of severe pediatric and adult leptospirosis in S?o Paulo, Brazil

机译：巴西圣保罗严重儿科和成人钩端螺旋体病的比较分析

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摘要

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?o Paulo during 2004-2006. A total of 42 case-patients <18 years of age and 328 case-patients ≥ 18 years of age were tested during the study. Compared with children, adults had higher rates of jaundice (P = 0.01), elevated serum bilirubin levels (P < 0.01), oliguria (P = 0.02), and elevated creatinine levels (P = 0.01) but not for thrombocytopenia or pulmonary involvement. The overall case-fatality rate was 27% (adult) versus 5% (pediatric) (P < 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.
机译：尽管钩端螺旋体病在儿童时期可能致命，但许多在疾病流行地区工作的临床医生的经验是，经典的威尔氏病和死亡在儿科患者中较少见。该研究的目的是确定在大量高危人群中严重儿科和成人钩端螺旋体病的疾病谱和结果差异。在2004-2006年期间从圣保罗获得了住院病例的流行病学，临床和实验室数据。在研究过程中，总共对42名18岁以下的案例患者和328名18岁以上的案例患者进行了测试。与儿童相比，成人的黄疸发生率较高（P = 0.01），血清胆红素水平较高（P <0.01），少尿（P = 0.02），肌酐水平较高（P = 0.01），而血小板减少症或肺部受累则没有。总体病死率是27％（成人），而5％（儿科）（P <0.01）。严重的小儿钩端螺旋体病可能不太可能表现出威尔氏病的所有经典特征，并且致命性可能不如成年人。

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