Paroxysmal atrial fibrillation: an unusual association of leptospirosis

Authors

  • Sathwik Raj Department of General Medicine, KVG Medical College, Sullia, Karnataka, India
  • Prakash Rao Department of General Medicine, KVG Medical College, Sullia, Karnataka, India
  • Rame Gowda Department of General Medicine, KVG Medical College, Sullia, Karnataka, India
  • C. Ramachandra Bhat Department of General Medicine, KVG Medical College, Sullia, Karnataka, India

Keywords:

Leptospirosis, Atrial fibrillation, Thrombocytopenia, Subconjunctival hemorrhage

Abstract

A 60 year old nonsmoker, non-diabetic, normotensive farmer presented with 4 days history of fever, myalgia & headache. He had relative bradycardia, eye congestion, diffuse muscle tenderness and tender hepatomegaly at presentation. He developed subconjunctival hemorrhage on 3rd in-hospital day. His investigations showed thrombocytopenia, hepatic and renal dysfunctions. His leptospira serology was positive. He was treated with injection crystalline penicillin and supportive therapy. While on treatment, even though he did not have any known cardiac risk factors, except for his age & gender, he developed 3 paroxysms of atrial fibrillation on 5th - 7th in-hospital days, without hemodynamic instability. His cardiac markers and echocardiogram during the paroxysms were otherwise normal. He had uneventful recovery, remained in sinus rhythm and stable at follow-up. This paroxysmal atrial fibrillation may be a coincidence or attributed as unusual association of leptospirosis.

References

Vinetz MJ, Leptospirosis. In: Longo DL, Kasper DL, eds. Harrison`s Principles Of Internal Medicine. 18th ed. New York: Mc Graw Hill; 2012: 1392-1396.

Navinan MR, Rajapakse S, Cardiac involvement in leptospirosis. Royal Soc Trop Med Hyg. 2012 Sep;106(9):515-20.

Skerk V, Markotić A, Puljiz I, et al. Electrocardiographic changes in hospitalized patients with leptospirosis over a 10-year period. Med Sci Monit. 2011;17(7):CR369-75.

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Published

2017-02-10

Issue

Section

Case Reports