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Total atrioventricular block as a cardiac manifestation in Weil’s disease: a case report
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Total atrioventricular block as a cardiac manifestation in Weil’s disease: a case report
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Journal Article
Total atrioventricular block as a cardiac manifestation in Weil’s disease: a case report
2025
Overview
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.
Publisher
BioMed Central,BioMed Central Ltd,BMC
Subject
/ Atrioventricular Block - diagnosis
/ Atrioventricular Block - etiology
/ Atrioventricular Block - microbiology
/ Atrioventricular Block - physiopathology
/ Atrioventricular Block - therapy
/ Diseases
/ Female
/ Humans
/ Medicine
/ Shock
/ total atrioventricular block
/ Weil Disease - complications
