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LEPTOSPİRA' YA BAĞLI MİYOKARDİT OLGUSU

ACUTE MYOCARDITIS DISCLOSING LEPTOSPIRE

Journal Name:

  • İstanbul Tıp Fakültesi Dergisi

Publication Year:

  • 2006

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Leptospirosis is a widespread zoonosis in the world. It is commonly spread by contaminated nutrient and water by mouse stool. Leptospirosis is rarely observed in our country. The prevalance is especially higher among young men in the spring and summer. The 90% of these cases are nonicteric and the 5-10% of cases have symptomps of Weil disease which are icteric hemorrhage, renal failure and fever. Hemorrhagic myocarditis is infrequently observed. In addition to clinical signs of infection including high levels of CRP, ESR, high fever, we identified high levels of AST, LDH, CPK, CK-MB, Troponin I, sinusal tachycardia and increasing T positive wave between V1-5 in ECG in our case. Myocarditis was considered according to global hypocinesis and the decrease of ejection fraction in the echocardiography. No coronary artery disease had been found in the findings of exercise tecnesium myocard perfusion scintigraphy which was done for specific diagnosis. Autoantibodies were found negative and cultures were sterile. Leptospire were shown with microscopic test. The patient was treated with penicilline exhibited recovery clinical and laboratuary tests and no additional complication in the following two years. This case report was published because of myocarditis related to leptospire is very uncommon.
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Abstract (Original Language): 
Leptospiroz, tüm dünyada yayg›n olarak görülen bir zoonozdur. En s›k fare d›flk›lar› ile kirlenmifl besin maddeleri ve su ile bulaflma olur. Ülkemizde sporadik olarak rastlanmaktad›r. S›kl›kla genç erkeklerde ilkbahar ve yaz mevsiminde görülmektedir. Olgular›n %90'› sar›l›ks›zd›r; %5-10 olguda Weil hastal›¤› bulgular› olan sar›l›k, kanamaya e¤ilim, renal yetersizlik, atefl vard›r. Nadir olguda hemorajik miyokardit görülür. Olgumuzda enfeksiyon hastal›klar›n› düflündüren CRP yüksekli¤i, sedimantasyon yüksekli¤i, sola kayma, yüksek atefl bulgular› yan›nda AST, LDH, CPK, CK-MB, Troponin I yüksekli¤i vard›. EKG'de sinusal taflikardi ve V1-5 aras› T sivrili¤i bulunmaktayd›. Ekokardiografide miyokardit düflündürebilecek global hipokinezi ve ejeksiyon fraksiyonu düflüklü¤ü görüldü. Ay›r›c› tan› amac›yla yap›lan egzersiz tecnesium miyokard perfüzyon sintigrafisi bulgular› ile koroner arter hastal›¤› olmad›¤› gösterildi. Otoantikorlar negatif bulundu. Kültürler steril kald›. Latex ve karanl›k alan mikroskobisi ile leptospira gösterildi. Kristalize penisilin tedavisi ile tüm klinik ve laboratuvar tetkikleri düzelen hasta; iki y›l takipte ek bir sorun ç›karmad›. Leptospira'ya ba¤l› miyokardit görülmesi çok nadir oldu¤undan yay›nland›.
FULL TEXT (PDF): 
PDF icon arastirmax-leptospira-ya-bagli-miyokardit-olgusu.pdf
  • 3
87-89
  • Turkish

REFERENCES

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