Abstract
Leptospirosis is a life-threatening zoonotic disease of global distribution. It has variable presentation ranging from mild febrile illness to life-threatening complications like acute renal failure, acute hepatic failure, pulmonary hemorrhages and cardiac arrhythmias. Cardiac manifestations of leptospirosis are not uncommon but are underdiagnosed. Cardiac manifestations may vary from minor rhythm abnormalities to fatal ventricular arrhythmias. We report an unusual presentation of leptospirosis in a patient who presented to the Emergency Department with epigastric pain and congestive cardiac failure with rhythm disturbances and selective myocardial involvement mimicking as Non ST elevation Inferior wall myocardial infarction (NSTEMI). The Cardiac manifestations of Leptospirosis need meticulous intensive care management as the mortality rate is very high in this subset of patients. Index suspicion and early treatment remains the mainstay of this life threatening zoonotic disease.
Highlights
Leptospirosis is a potentially fatal zoonotic disease which is caused by the pathogenic spirochete of genus leptospira, known to cause multiorgan dysfunction including acute renal failure, severe rhabdomyolysis, hepatic dysfunction, pulmonary haemorrhages and myocarditis [1]
We report an unusual presentation of leptospirosis in a patient who presented to the Emergency Department
As the patient was from endemic area for Malaria, Dengue and Leptospirosis, we started the patient on injectable anti-malarials and Ceftrioxone along with Noradrenalin infusion for hypotension and Injectable diuretics for congestive cardiac failure
Summary
Leptospirosis is a potentially fatal zoonotic disease which is caused by the pathogenic spirochete of genus leptospira, known to cause multiorgan dysfunction including acute renal failure, severe rhabdomyolysis, hepatic dysfunction, pulmonary haemorrhages and myocarditis [1]. It is a disease of worldwide distribution. Cardiac manifestations of leptospirosis are not uncommon but are underdiagnosed [1].
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