Total atrioventricular block as a cardiac manifestation in Weil’s disease: a case report
Abstract Background Weil’s disease is an infection caused by Leptospira bacteria. Leptospirosis may cause arrhythmias, such as atrial fibrillation and ST-T segment changes. We report a rare case of total atrioventricular block induced by leptospirosis. Early diagnosis and prompt management present p...
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BMC
2025-03-01
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| Series: | Journal of Medical Case Reports |
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| Online Access: | https://doi.org/10.1186/s13256-024-04970-w |
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| author | Ivana Purnama Dewi Arya Taksya Bagaskara Andreas Mercyan Anggitama Kadex Reisya Sita Damayanti Ihdinal Mukti |
| author_facet | Ivana Purnama Dewi Arya Taksya Bagaskara Andreas Mercyan Anggitama Kadex Reisya Sita Damayanti Ihdinal Mukti |
| author_sort | Ivana Purnama Dewi |
| collection | DOAJ |
| description | Abstract Background Weil’s disease is an infection caused by Leptospira bacteria. Leptospirosis may cause arrhythmias, such as atrial fibrillation and ST-T segment changes. We report a rare case of total atrioventricular block induced by leptospirosis. Early diagnosis and prompt management present particular challenges. Case report A 43-year-old Asian woman was referred from internal medicine to cardiology owing to an electrocardiogram abnormality. She complained of worsening chest discomfort 3 days earlier, accompanied by fever, nausea, and intermittent headaches. The patient appeared lethargic and jaundiced; blood pressure was 81/43 mmHg, heart rate was 41 bpm, respiratory rate was 20 times/minute, and temperature was 38.2 °C. The electrocardiogram showed a total atrioventricular block with a junctional escape rhythm of 45 bpm. Laboratory tests revealed increased renal and liver function, thrombocytopenia (98,000/µL), and positive immunoglobulin G and M anti-Leptospira. The patient was diagnosed with Weil’s disease (Faine’s score 32) and total atrioventricular block. The initial management involved fitting the patient with a transcutaneous pacemaker and giving dopamine 5 mcg/kgBW/minute, titrated to a target systolic blood pressure of > 90 mmHg. The patient was also scheduled to undergo temporary transvenous pacing. However, the patient died of suspected cardiogenic shock due to a deterioration in clinical condition. Conclusion Leptospirosis can cause rare but fatal arrhythmias, as seen in this case of fulminant leptospirosis with total atrioventricular block. Clinicians should be vigilant and consider this potential complication in similar cases. |
| format | Article |
| id | doaj-art-d11304b95a4d45899f83b09f80ca5148 |
| institution | DOAJ |
| issn | 1752-1947 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Medical Case Reports |
| spelling | doaj-art-d11304b95a4d45899f83b09f80ca51482025-08-20T02:59:22ZengBMCJournal of Medical Case Reports1752-19472025-03-011911610.1186/s13256-024-04970-wTotal atrioventricular block as a cardiac manifestation in Weil’s disease: a case reportIvana Purnama Dewi0Arya Taksya Bagaskara1Andreas Mercyan Anggitama2Kadex Reisya Sita Damayanti3Ihdinal Mukti4Faculty of Medicine, Duta Wacana Christian UniversityFaculty of Medicine, Duta Wacana Christian UniversityFaculty of Medicine, Duta Wacana Christian UniversityFaculty of Medicine, Duta Wacana Christian UniversityDepartment of Internal Medicine, West Papua General HospitalAbstract Background Weil’s disease is an infection caused by Leptospira bacteria. Leptospirosis may cause arrhythmias, such as atrial fibrillation and ST-T segment changes. We report a rare case of total atrioventricular block induced by leptospirosis. Early diagnosis and prompt management present particular challenges. Case report A 43-year-old Asian woman was referred from internal medicine to cardiology owing to an electrocardiogram abnormality. She complained of worsening chest discomfort 3 days earlier, accompanied by fever, nausea, and intermittent headaches. The patient appeared lethargic and jaundiced; blood pressure was 81/43 mmHg, heart rate was 41 bpm, respiratory rate was 20 times/minute, and temperature was 38.2 °C. The electrocardiogram showed a total atrioventricular block with a junctional escape rhythm of 45 bpm. Laboratory tests revealed increased renal and liver function, thrombocytopenia (98,000/µL), and positive immunoglobulin G and M anti-Leptospira. The patient was diagnosed with Weil’s disease (Faine’s score 32) and total atrioventricular block. The initial management involved fitting the patient with a transcutaneous pacemaker and giving dopamine 5 mcg/kgBW/minute, titrated to a target systolic blood pressure of > 90 mmHg. The patient was also scheduled to undergo temporary transvenous pacing. However, the patient died of suspected cardiogenic shock due to a deterioration in clinical condition. Conclusion Leptospirosis can cause rare but fatal arrhythmias, as seen in this case of fulminant leptospirosis with total atrioventricular block. Clinicians should be vigilant and consider this potential complication in similar cases.https://doi.org/10.1186/s13256-024-04970-wLeptospirosisWeil’s diseasetotal atrioventricular block |
| spellingShingle | Ivana Purnama Dewi Arya Taksya Bagaskara Andreas Mercyan Anggitama Kadex Reisya Sita Damayanti Ihdinal Mukti Total atrioventricular block as a cardiac manifestation in Weil’s disease: a case report Journal of Medical Case Reports Leptospirosis Weil’s disease total atrioventricular block |
| title | Total atrioventricular block as a cardiac manifestation in Weil’s disease: a case report |
| title_full | Total atrioventricular block as a cardiac manifestation in Weil’s disease: a case report |
| title_fullStr | Total atrioventricular block as a cardiac manifestation in Weil’s disease: a case report |
| title_full_unstemmed | Total atrioventricular block as a cardiac manifestation in Weil’s disease: a case report |
| title_short | Total atrioventricular block as a cardiac manifestation in Weil’s disease: a case report |
| title_sort | total atrioventricular block as a cardiac manifestation in weil s disease a case report |
| topic | Leptospirosis Weil’s disease total atrioventricular block |
| url | https://doi.org/10.1186/s13256-024-04970-w |
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