Cardiovascular lesions in leptospirosis: An autopsy study

Chakurkar, Girish; Vaideeswar, Pradeep; Pandit, Shobhana P.; Divate, Smita

doi:10.1016/j.jinf.2007.12.007

Cited by 40 publications

(26 citation statements)

References 10 publications

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“…Cardiac involvement is usually subclinical, in milder forms, or masked by pulmonary hemorrhage, in severe leptospirosis 8 . Most of the reports have been clinical and tachycardia, electrocardiogram (ECG) abnormalities and refractory hypotension are the usual clinical manifestations 1,[10][11][12] . Pericardial effusion has been reported in patients with leptospirosis and advanced renal failure, suggesting a possible role for uremia in such patients 12 .…”

Section: IImentioning

confidence: 99%

“…Disseminated intravascular coagulation can also play an important role in leptospirosis-associated cardiac involvement 9 . Autopsy studies have shown a high prevalence of cardiac involvement in severe leptospirosis, with up to 96% of patients dying from such disease 8,11 . The autopsy findings are many; cardiomegaly, pericardic hemorrhage, perivascular inflammation, endocarditis and intimitis of coronary arteries and of the aorta were among the features of cardiac damage 8,11 .…”

Section: IImentioning

confidence: 99%

“…Autopsy studies have shown a high prevalence of cardiac involvement in severe leptospirosis, with up to 96% of patients dying from such disease 8,11 . The autopsy findings are many; cardiomegaly, pericardic hemorrhage, perivascular inflammation, endocarditis and intimitis of coronary arteries and of the aorta were among the features of cardiac damage 8,11 . The predominant histophatological finding was an interstitial myocarditis, present in up to 96% of the studies mentioned and highly associated with inflammation of the conduction system 8,11 .…”

Section: IImentioning

confidence: 99%

“…The autopsy findings are many; cardiomegaly, pericardic hemorrhage, perivascular inflammation, endocarditis and intimitis of coronary arteries and of the aorta were among the features of cardiac damage 8,11 . The predominant histophatological finding was an interstitial myocarditis, present in up to 96% of the studies mentioned and highly associated with inflammation of the conduction system 8,11 . Electrocardiographic abnormalities may be found in numerous patients undergoing hospitalization for leptospirosis treatment.…”

Section: IImentioning

confidence: 99%

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Atrial flutter complicating severe leptospirosis: a case report

Silva

Benevides

et al. 2013

Rev. Soc. Bras. Med. Trop.

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Cardiac disturbances are relatively common and electrocardiographic abnormalities may be found in more than 70% of patients with leptospirosis. We report the case of a 68 year-old male with severe leptospirosis who developed atrial flutter. Effective treatment was done with amiodarone. The patient became clinical stable, with complete recovery. Rigorous clinical observation and continuous electrocardiogram (ECG) monitoring may facilitate the identification of rhythm disorders, and thus prevent a probable fatal outcome, in severe cases of leptospirosis.

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Section: IImentioning

confidence: 99%

Section: IImentioning

confidence: 99%

Section: IImentioning

confidence: 99%

Section: IImentioning

confidence: 99%

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Atrial flutter complicating severe leptospirosis: a case report

Silva

Benevides

et al. 2013

Rev. Soc. Bras. Med. Trop.

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“…Entretanto, são frequentes casos de coexistência de lesões pulmonares e cardíacas na doença 3,12 . Documentar esses possíveis comprometimentos cardíacos na doença não foi objetivo do presente estudo.…”

Section: Discussionunclassified

Aspectos funcionais respiratórios na leptospirose humana

Fontes

Ribeiro

Jesus

et al. 2010

Rev. Soc. Bras. Med. Trop.

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RESUMOIntrodução: O comprometimento respiratório da leptospirose humana pode ser sua principal manifestação clínica e comumente está associado a maior morbimortalidade. Métodos: Objetivando descrever aspectos funcionais respiratórios nessa doença, foram analisados 21 pacientes com oximetrias de pulso e espirometrias em dois momentos: em avaliação inicial e após cerca de 28 dias. Resultados: Dois (9,5%) doentes tinham saturação periférica de oxigênio menor que 95%. Padrões espirométricos normais foram observados em 8 (38,1%) casos; distúrbios ventilatórios restritivos foram inferidos em 7 (33,3%), obstrutivos com capacidade vital forçada reduzida em 4 (19%), e inespecíficos em 2 (9,5%). Espirometrias anormais se associaram a pior escore APACHE II (p=0,02) e anormalidades na radiografia de tórax (p=0,05). Após resolução clínica, verificou-se ganho funcional significativo (p<0,05) no grupo de pacientes com espirometria alterada. Conclusões: Alterações espirométricas foram detectadas no curso da enfermidade e estiveram associadas a pior gravidade clínica e maior freqüência de anormalidades radiológicas torácicas. Palavras-chaves:Leptospirose. Leptospirose pulmonar. Espirometria. ABSTRACTIntroduction: Respiratory impairment may be the main clinical manifestation of human leptospirosis. Methods: With the aim of describing the respiratory functional characteristics of this disease, 21 patients were evaluated using pulse oximetry and spirometry at two times: an initial evaluation and after around 28 days. Results: Two (9.5%) patients presented peripheral oxygen saturation of less than 95%. Normal spirometric patterns were observed in eight (38.1%); cases restrictive ventilatory disorders were inferred in seven (33.3%), obstructive disorders with reduced forced vital capacity in four (19%), and nonspecific disorders in two (9.5%). Abnormal spirometry findings were associated with worse APACHE II scores (p = 0.02) and abnormalities on chest x-ray (p = 0.05). After clinical resolution, significant functional gain was observed (p < 0.05) in the group of patients with abnormal spirometry findings. Conclusions: It was concluded that respiratory functional abnormalities were detected during the course of the disease and were associated with greater clinical severity and higher frequency of chest radiographic abnormalities.

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