Pericarditis as a cardiac manifestation of acute leptospirosis

M Zechel,M Franz,S Hagel,B T Schleenvoigt,M Baier

doi:10.1007/s15010-020-01496-3

Abstract

Leptospirosis is an infectious disease with an increasing incidence worldwide. The clinical presentation is unspecific and ranges from an asymptomatic clinical course to an acute fulminant disease. The current case report describes a 32-year-old male patient who presented with ST segment elevation in the electrocardiogram about 14 days after cross-country running. Pericarditis was diagnosed and linked to an acute leptospirosis that was serologically confirmed.

Highlights

Leptospirosis is a zoonosis transmitted across the world
After 14 days from his discharge, the polymerase chain reaction in blood was negative for leptospirosis
The standard test for leptospirosis, the micro-agglutination testing (MAT), confirmed the finding and revealed a titer of 100 for Leptospira kirschneri in a serum sample taken on day 8 of hospitalization, which further supports the diagnosis according to the WHO criteria [15]

Summary

Introduction

Leptospirosis is a zoonosis transmitted across the world. In tropical and subtropical countries, leptospirosis is prevalent with an incidence of 10–100/100,000 inhabitants. The infective pathogen Leptospira interrogans belongs to the family of Leptospiraceae. These are obligatory aerobic, hanger-like bacteria [3]. A 32-year-old otherwise healthy man was admitted to a ward for internal medicine in October 2016 He complained of fever (up to 39 °C), pain in the right leg as well as tingle in the right arm for just 15 min at home. For further treatment of a suspected endocarditis, the patient was transferred to the intermediate care unit at university hospital Jena on day 2 of hospitalization. After 14 days from his discharge, the polymerase chain reaction in blood was negative for leptospirosis. No pathological findings could be revealed and the computed tomography of the heart was inconspicuous one month after discharge. A second MAT screening as well as a testing of immunoglobulin M and G was negative 3.5 years later

Discussion

Findings

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