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Brain & Heart Cardiac involvement in leptospirosis

Table 1. Various laboratory parameters observed during the patient’s admission and follow-up
Application day 3 day 7 day 14 day
rd
th
th
WBC (mm ) 1600 6770 11210 7580
3
Hemoglobin 14.3 13.8 13 13
Neutrophil 65 74 73 75
Platelet (mm ) 95 43 110 254
3
Aspartate aminotransferase (U/L) 89 98 61 44
Alanine aminotransferase (U/L) 28 68 63 46
Total bilirubin (mg/dL) 1.47 1.16 0.9 1.1
Alkalen fosfataz (U/L) 38 59 49 59
Gama glutamil transferaz (U/L) 13 37 54 39
Creatine kinase (U/L) 4555 1162 292 61
Creatine kinase-MB (U/L) 68 46 12 24
Troponin (ng/mL) 6415 549 6 6
Urea 112 65 58 41
Creatinine 2.14 0.95 0.7 0.57
C-reaktive protein (mg/l) 194 31 20 7
Procalcitonin (ng/mL) 100 4.6 0.7 0.2
Erythrocyte sedimentation rate (mm/h) 18 19 13 36
Urine leukocyte 6 1 8 2
Urine protein + ++ - -
Abbreviation: WBC: White blood cell.

A A B

B
Figure 2. Echocardiogram image of the patient (A) Apical four-chamber
view (left ventricular [LV] diastole). (B) Apical four-chamber view (LV
systole).
Urban outbreaks are frequent in areas with poor hygiene
and high rodent populations. Leptospirosis predominantly
12
affects economically disadvantaged groups and results in
significant morbidity and mortality (5% – 15%). 11,13
Figure 1. Electrocardiogram image of the patient. (A) Extremity Leptospirosis is typically transmitted through direct
derivations (limb leads). (B) Chest leads (precordial leads). contact with infected animal urine or exposure to soil or
14
infection worldwide. It is caused by a motile, obligate water contaminated with this urine. High-risk individuals
1-3
aerobic, non-spore-forming, and non-capsulated include farmers, those who work closely with animals,
microorganism. 10 those exposed to rodents, those living in areas with poor
sanitation, and individuals engaged in water sports. 11,13
Leptospirosis is estimated to cause one million cases
and 58,900 deaths annually, with a case fatality rate of The incubation period for leptospirosis is 2 – 20 days,
6.85%. Although its overall incidence has remained stable with an average of 7 – 12 days. Some patients experience a
11
worldwide, major outbreaks often occur after floods and biphasic course of the disease: An initial acute or septicemic
natural disasters. 11 phase lasting about a week, followed by an immune phase

Volume 2 Issue 4 (2024) 3 doi: 10.36922/bh.3496