Severe circulatory failure caused by acute cardiac dysfunction in a young man with leptospirosis living in a slum of Rome, Italy (REV JI-PH-D-24–01876R3)

Leptospirosis may cause severe disease characterized by acute kidney injury, hepatic failure, or multiorgan dysfunction, including cardiac manifestations. The incidence and severity of cardiac involvement in leptospirosis are underreported and poorly understood. Moreover, left ventricular dysfunctio...

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Main Authors: Salvatore Lucio Cutuli, Fabiana Rizzo, Gennaro De Pascale, Silvia Costantini, Anna Maria Marella, Massimo Antonelli, Alessandra Ciervo
Format: Article
Language:English
Published: Elsevier 2025-11-01
Series:Journal of Infection and Public Health
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Online Access:http://www.sciencedirect.com/science/article/pii/S1876034125002643
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author Salvatore Lucio Cutuli
Fabiana Rizzo
Gennaro De Pascale
Silvia Costantini
Anna Maria Marella
Massimo Antonelli
Alessandra Ciervo
author_facet Salvatore Lucio Cutuli
Fabiana Rizzo
Gennaro De Pascale
Silvia Costantini
Anna Maria Marella
Massimo Antonelli
Alessandra Ciervo
author_sort Salvatore Lucio Cutuli
collection DOAJ
description Leptospirosis may cause severe disease characterized by acute kidney injury, hepatic failure, or multiorgan dysfunction, including cardiac manifestations. The incidence and severity of cardiac involvement in leptospirosis are underreported and poorly understood. Moreover, left ventricular dysfunction is considered a rare complication in seen in leptospirosis cases. We present a case of leptospirosis in a 19-year-old male, living in a slum in Rome-Italy, without a previous cardiovascular history, who developed septic shock, and severe non-ischemic left ventricular systolic dysfunction following leptospirosis infection. In this setting, the patient developed KDIGO stage 3 acute kidney injury and acute circulatory failure, and requiring high dose norepinephrine and dobutamine. Empiric wide-spectrum antibiotic therapy with Piperacillin-Tazobactam was started early after the recognition of sepsis, and was deemed appropriate after the serological confirmation of leptospirosis. Patient’s clinical condition progressively improved and he was discharged after 21 days of hospital stay (6 of those were in the intensive care unit), with full organ function recovery.To conclude, this case report supports the need for preventive public health interventions aiming to reduce the burden of environmentally transmitted life-threatening infectious diseases, including leptospirosis, by promoting sanitation and infrastructures, in order to prevent unequal health outcomes.
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spelling doaj-art-fb88ed0acf0f45cd8124d03607fc5aa12025-08-20T04:02:14ZengElsevierJournal of Infection and Public Health1876-03412025-11-01181110291510.1016/j.jiph.2025.102915Severe circulatory failure caused by acute cardiac dysfunction in a young man with leptospirosis living in a slum of Rome, Italy (REV JI-PH-D-24–01876R3)Salvatore Lucio Cutuli0Fabiana Rizzo1Gennaro De Pascale2Silvia Costantini3Anna Maria Marella4Massimo Antonelli5Alessandra Ciervo6Department of Emergency, Intensive Care Medicine and Anesthesia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy; Department of Basic Biotechnology Sciences, Intensive and Perioperative Clinics, Università Cattolica del Sacro Cuore, Rome, ItalyDepartment of Infectious Diseases, Istituto Superiore di Sanità, Rome, ItalyDepartment of Emergency, Intensive Care Medicine and Anesthesia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy; Department of Basic Biotechnology Sciences, Intensive and Perioperative Clinics, Università Cattolica del Sacro Cuore, Rome, ItalyDepartment of Infectious Diseases, Istituto Superiore di Sanità, Rome, ItalyDepartment of Infectious Diseases, Istituto Superiore di Sanità, Rome, ItalyDepartment of Emergency, Intensive Care Medicine and Anesthesia, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy; Department of Basic Biotechnology Sciences, Intensive and Perioperative Clinics, Università Cattolica del Sacro Cuore, Rome, ItalyDepartment of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy; Correspondence to: Department of Infectious Diseases, Istituto Superiore di Sanità, Viale Regina Elena 299, Rome 00161, Italy.Leptospirosis may cause severe disease characterized by acute kidney injury, hepatic failure, or multiorgan dysfunction, including cardiac manifestations. The incidence and severity of cardiac involvement in leptospirosis are underreported and poorly understood. Moreover, left ventricular dysfunction is considered a rare complication in seen in leptospirosis cases. We present a case of leptospirosis in a 19-year-old male, living in a slum in Rome-Italy, without a previous cardiovascular history, who developed septic shock, and severe non-ischemic left ventricular systolic dysfunction following leptospirosis infection. In this setting, the patient developed KDIGO stage 3 acute kidney injury and acute circulatory failure, and requiring high dose norepinephrine and dobutamine. Empiric wide-spectrum antibiotic therapy with Piperacillin-Tazobactam was started early after the recognition of sepsis, and was deemed appropriate after the serological confirmation of leptospirosis. Patient’s clinical condition progressively improved and he was discharged after 21 days of hospital stay (6 of those were in the intensive care unit), with full organ function recovery.To conclude, this case report supports the need for preventive public health interventions aiming to reduce the burden of environmentally transmitted life-threatening infectious diseases, including leptospirosis, by promoting sanitation and infrastructures, in order to prevent unequal health outcomes.http://www.sciencedirect.com/science/article/pii/S1876034125002643LeptospirosisSerovarsSeptic shockAcute cardiac dysfunction
spellingShingle Salvatore Lucio Cutuli
Fabiana Rizzo
Gennaro De Pascale
Silvia Costantini
Anna Maria Marella
Massimo Antonelli
Alessandra Ciervo
Severe circulatory failure caused by acute cardiac dysfunction in a young man with leptospirosis living in a slum of Rome, Italy (REV JI-PH-D-24–01876R3)
Journal of Infection and Public Health
Leptospirosis
Serovars
Septic shock
Acute cardiac dysfunction
title Severe circulatory failure caused by acute cardiac dysfunction in a young man with leptospirosis living in a slum of Rome, Italy (REV JI-PH-D-24–01876R3)
title_full Severe circulatory failure caused by acute cardiac dysfunction in a young man with leptospirosis living in a slum of Rome, Italy (REV JI-PH-D-24–01876R3)
title_fullStr Severe circulatory failure caused by acute cardiac dysfunction in a young man with leptospirosis living in a slum of Rome, Italy (REV JI-PH-D-24–01876R3)
title_full_unstemmed Severe circulatory failure caused by acute cardiac dysfunction in a young man with leptospirosis living in a slum of Rome, Italy (REV JI-PH-D-24–01876R3)
title_short Severe circulatory failure caused by acute cardiac dysfunction in a young man with leptospirosis living in a slum of Rome, Italy (REV JI-PH-D-24–01876R3)
title_sort severe circulatory failure caused by acute cardiac dysfunction in a young man with leptospirosis living in a slum of rome italy rev ji ph d 24 01876r3
topic Leptospirosis
Serovars
Septic shock
Acute cardiac dysfunction
url http://www.sciencedirect.com/science/article/pii/S1876034125002643
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