Leptospirosis presenting as severe cardiogenic shock: A case report

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Abstract

Background: Leptospirosis is a rare infectious illness caused by the Spirochaete Leptospira. It has a wide-varying spectrum of presentation. We present a rare case of severe cardiogenic shock secondary to leptospirosis, in the absence of its common clinical features. Case presentation: A 36-year-old woman presented to our unit with severe cardiogenic shock and subsequent multi-organ failure. Her clinical course was characterised by ongoing pyrexia of unknown origin with concurrent cardiac failure. She was initially managed with broad-spectrum antibiotics and inotropes. Percutaneous cardiac biopsy excluded major causes of myocarditis. On day 21 after presentation, she was found to be IgM-positive for leptospirosis. Conclusions: This is a rare case of severe cardiogenic shock secondary to leptospirosis infection. The case also highlights the importance of obtaining a thorough social history when assessing a patient with an unusual presentation, as clues can often be missed.

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Forbat, E., Rouhani, M. J., Pavitt, C., Patel, S., Handslip, R., & Ledot, S. (2018). Leptospirosis presenting as severe cardiogenic shock: A case report. Journal of the Intensive Care Society, 19(4), 351–353. https://doi.org/10.1177/1751143718754993

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