Abstract

Background/aim In leptospirosis, although cardiac involvement in the form of ECG changes and myocarditis is known, it is not considered to be significant. This study analysed cardiac changes in leptospirosis.

Methods Twenty-four hearts from patients who had died from leptospirosis were studied. Detailed gross and light microscopic examination was carried out.

Results Myocarditis was noted in 96% of cases. Endocardial inflammation was seen in 50% of cases. This endocardial inflammation correlates with vasculitis, which is the principal pathogenetic mechanism of the disease.

Conclusions There is definite cardiac involvement in leptospirosis, which even though not symptomatically evident, may add to the morbidity or be contributory to the mortality associated with the disease. In addition, a possibility of dilated cardiomyopathy as a delayed consequence of severe myocarditis remains, and may need evaluation.