Leptospirosis in children: A review for family physicians

Leptospirosis is an important cause of acute febrile illness in the monsoon season in India. It is a zoonotic disease that is spread primarily by rodents. There exist two clinical types: anicteric and icteric leptospirosis. Both have an initial septicemic phase followed by an immune phase. The clinical manifestations vary and the disease manifestations may range from a nonspecific febrile illness to one with severe multiorgan failure. Weil′s disease is the severe form of the infection; which occurs in less than 10% of the patients and is associated with high mortality. The methods available for diagnosis and treatment of leptospirosis are discussed in this review. Crystalline penicillin is the drug of choice for treatment of leptospirosis in children. Avoidance of contact with flood waters and rodent control are vital for prevention of the disease. We also discuss the differences between childhood leptospirosis and adult disease. We used two methods to garner the information presented in this article: i) we searched the PubMed database (http://www.ncbi.nlm.nih.gov/pubmed/) using the keywords ′leptospirosis′ and ′children,′ with special emphasis given to articles from the Indian literature; and ii) we reviewed the chapters on leptospirosis in the standard textbooks of pediatric and infectious diseases.