title: [Severe myocardial damage caused by leptospirosis. Report of a fatal case in Mexico].
abstract: Chagasic cardiomyopathy is a common disease in Latin America, however similar clinical pictures exist that can be confused with this, as they give negative results to the tests that detects T. cruzi, like non Chagasic rural endemic chronic cardiopathy, highly common in Venezuela. Using histopathology techniques, "idiopathic cardiomyopathy" is frequently found as the cause of death when the etiology of this disease is not known. This paper presents the case of a man of 26-years-old who died of dilated cardiomyopathy secondary to leptospirosis. Clinically, in addition to the cardiac failure, jaundice, hyperbilirubinemia, transaminases increase, proteinuria and hematuria were present. Initially it was suspected Chagasic cardiomyopathy but the epidemiologic background and the parasitologic and serologic tests for T. cruzi gave negative results. The dark field microscopy videorecording of blood and urine samples, argentic impregnation and immunohistochemistry tests as well as haemoculture in EMJH medium were positive for L. interrogans serovar Pomona. Postmortem we confirmed the presence of leptospira in different tissues through of histopathology, argentic impregnation, indirect immunofluorescence and immunohistochemistry.
authors.affiliation: Laboratorio de Medicina Tropical, Departamento de Medicina Experimental, Facultad de Medicina, UNAM-Hospital General de México, Organo Descentralizado, Secretaría de Salud, México, DF. oscarvel1@yahoo.com.mx
authors.forename: Oscar
authors.initials: O
authors.lastname: Velasco-Castrejón
authors.forename: Beatriz
authors.initials: B
authors.lastname: Rivas-Sánchez
authors.forename: Juan
authors.initials: J
authors.lastname: Soriano-Rosas
authors.forename: Héctor Hugo
authors.initials: HH
authors.lastname: Rivera-Reyes
mesh_terms: D000328:Adult; D002311:Cardiomyopathy, Dilated / Q000382:microbiology*; D017809:Fatal Outcome; D006801:Humans; D007922:Leptospirosis / Q000150:complications*; D008297:Male; D008800:Mexico; D012720:Severity of Illness Index