Leptospirosis: An Update - Part 1 Of 2: Etiology, Ecology, Epidemiology, Prophylaxis And Contro / Leptospirose: Uma actualização - Parte 1 De 2: Etiologia, Ecologia, Epidemiologia, Profilaxia e Controlo

Abstract

Leptospirosis belongs to the category of neglected infectious diseases and, due to its great epidemic potential, its local distribution in tropical regions is of extreme importance. It is a worldwide public health problem, known for the emergence and reappearance of the disease, lack of sanitary conditions and abandonment of the disease. Human infections usually occur after skin contact with soil and/or water contaminated by the urine of chronically infected mammals. The clinical manifestations of the disease range from mild fever, chills and flu-like symptoms to acute forms of the disease. Based on these brief considerations, this article - part 1 of 2 - aims to discuss the biological, ecoepidemiological, prophylactic and control aspects of leptospirosis in Brazil.

Leptospirosis in a patient with cardiac manifestation: A case report study and literature review

“…Around half of the patients also experience nausea, vomiting, and diarrhea, while 25%-35% may have a nonproductive cough. 8 Our patient presented with nonspecific symptoms, including weakness, lethargy, nausea, vomiting, myalgia, and fever, leading to an outpatient treatment for influenza. During the examination, notable findings such as scleral icterus, leg ulcer, a history of working in rice fields, and the presence of constitutional symptoms prompted consideration for a diagnosis of acute phase leptospirosis.…”

“…Interleukin‐1 and tumor necrosis factor‐α have been shown to induce arrhythmogenic effects in cultured cardiomyocytes, and their excessive presence in the perisinoatrial nodal region has been associated with the attenuation of sinoatrial node control over the heart and potential disruption of normal impulse transmission from the sinoatrial node to other parts of the heart. Moreover, it has been suggested that a glycoprotein component of the leptospiral cell wall may hinder the Na‐K ATPase, potentially leading to arrhythmias 1,5,8,10 …”

“…(Table 1). 7,8 F I G U R E 1 Shows an electrocardiogram of the patient. It demonstrates sinus bradycardia with normal QTc.…”

“…Moreover, it has been suggested that a glycoprotein component of the leptospiral cell wall may hinder the Na-K ATPase, potentially leading to arrhythmias. 1,5,8,10 Common electrocardiographic alterations seen in leptospirosis include conduction abnormalities, nonspecific ST-T changes, and atrial arrhythmias. 5 Furthermore, myocarditis and endocardial inflammation consistent with vasculitis can further complicate the cardiac manifestations of the disease.…”

“…Symptoms include abrupt fever, chills, muscle aches, and headaches. Around half of the patients also experience nausea, vomiting, and diarrhea, while 25%–35% may have a nonproductive cough 8 …”