Cardiovascular involvement in human and experimental leptospirosis: pathologic findings and immunohistochemical detection of leptospiral antigen.
Twenty hearts from patients dying of leptospirosis were studied. Interstitial myocarditis was found in 50% of the cases, and a significant statistical correlation was observed between myocarditis and the inflammatory involvement of the conduction tissue. Acute coronary arteritis, affecting the main branches of the coronary arteries, was observed in 70% of the cases, and this finding also correlates significantly with interstitial myocarditis. Aortitis was found in 57.8% of the cases. When serum against L. interrogans serovar icterohaemorrhagiae was used, focal IP antigen deposits were observed in the coronary arteries and in the aorta. Experimental data from 12 guinea-pigs inoculated with L. interrogans serovar icterohaemorrhagiae showed a focal myocarditis involving mainly the subendocardial and pericoronary heart tissue, with IP antigen deposits in the same sites. Leptospirosis might be visualized as a generalized illness resembling other infectious vasculitides. The heart and main vessels are involved during the septicaemic phase of the disease, and bacterial migration, toxin(s), enzymes and/or antigenic products liberated by bacterial lysis might account for the increased endothelial permeability with antigen deposits and inflammation.
de Brito
T
T
Faculty of Medicine, Department of Pathology, University of São Paulo, Brazil.
Morais
C F
CF
Yasuda
P H
PH
Lancellotti
C P
CP
Hoshino-Shimizu
S
S
Yamashiro
E
E
Alves
V A
VA
D000328:Adult; D000368:Aged; D000818:Animals; D000942:Antigens, Bacterial / Q000032:analysis*; D009202:Cardiomyopathies / Q000276:immunology / Q000473:pathology*; D005260:Female; D006168:Guinea Pigs; D006651:Histocytochemistry; D006801:Humans; D007124:Immunoenzyme Techniques; D007922:Leptospirosis / Q000276:immunology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009205:Myocarditis / Q000473:pathology
D000942:Antigens, Bacterial