Open AccessCardiac Involvement in Leptospirosis – An Unusual Manifestation
Author(s) -
Vanessa Barcelos,
Ana Carolina Ferreira,
A Fontes,
Luis Regagnan Dias,
Humberto Costa,
Dinis Martins
Publication year - 2020
Publication title -
european journal of case reports in internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.125
H-Index - 1
ISSN - 2284-2594
DOI - 10.12890/2020_001421
Subject(s) - leptospirosis , medicine , asymptomatic , chest pain , ejection fraction , cardiology , leptospira , shock (circulatory) , troponin , heart failure , pathology , myocardial infarction
Cardiovascular involvement by Leptospira is unusual. We report a case of a 29-year-old male sanitation worker who was diagnosed with leptospirosis (PCR testing for Leptospira spp. was positive in blood and urine). He had no classical clinical findings, and the presence of shock was the main worrisome finding. Within 24 hours of admission, the emergence of chest pain led us to consider cardiac involvement, which was demonstrated by diffuse supra-ST segment elevation, elevated troponin and NT-proBNP and an echocardiogram showing mildly left ventricular ejection fraction (LVEF 48–50%). There are several reports of cardiovascular involvement in severe leptospirosis but most patients are asymptomatic. In this case, the main key to diagnosis of perimyocarditis was the new onset of chest pain.