Lesjak Vesna, Pirnat Maja
Radiology, University Medical Centre Maribor, Maribor, SVN.
Cureus. 2023 Sep 16;15(9):e45345. doi: 10.7759/cureus.45345. eCollection 2023 Sep.
Severe leptospirosis is defined by multiple organ failure. Cardiac involvement is an uncommon complication in patients with leptospirosis, and the pathophysiology of it is not well understood. Diffuse myocardial calcifications connected with sepsis are infrequent, and their effect on heart function is hard to predict. They can lead to conduction disorders and arrhythmias, thereby causing sudden death. Myocardial calcifications are usually revealed incidentally by radiological investigations such as computed tomography (CT) scan in patients with or after sepsis and are commonly unidentified in practice because most cases progress gradually. This case report involves a 51-year-old male who presented to the emergency department with sepsis. The patient was diagnosed with leptospirosis, causing septic cardiomyopathy and diffuse calcifications of the myocardium of the left ventricle. This case highlights the importance of multimodality imaging and a multidisciplinary approach to diagnoses since early recognition and treatment are essential. Follow-up of such patients is necessary to monitor the systolic function of the left ventricle and cardiac arrhythmia.
重症钩端螺旋体病以多器官功能衰竭为特征。心脏受累是钩端螺旋体病患者中不常见的并发症，其病理生理学尚不清楚。与脓毒症相关的弥漫性心肌钙化并不常见，它们对心脏功能的影响难以预测。它们可导致传导障碍和心律失常，从而导致猝死。心肌钙化通常在脓毒症患者或脓毒症后患者中通过计算机断层扫描（CT）等放射学检查偶然发现，并且在实际中通常未被识别，因为大多数病例进展缓慢。本病例报告涉及一名51岁男性，他因脓毒症就诊于急诊科。该患者被诊断为钩端螺旋体病，导致感染性心肌病和左心室心肌弥漫性钙化。本病例强调了多模态成像和多学科诊断方法的重要性，因为早期识别和治疗至关重要。对此类患者进行随访对于监测左心室收缩功能和心律失常是必要的。
