Daño miocárdico grave por leptospirosis. Informe de un caso fatal en Mêxico.

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  • Additional Information
    • Alternate Title:
      Severe myocardial damage caused by leptospirosis. Report of a fatal case in Mexico.
    • Subject Terms:
      CARDIOMYOPATHIES; LEPTOSPIROSIS; LEPTOSPIRA; HISTOPATHOLOGY
    • Subject Terms:
      MEXICO; LATIN America
    • Abstract:
      La miocardiopatía chagásica es común en Latinoamérica, sin embargo, existen cuadros similares que se pueden confundir con ésta, pero son negativos a las pruebas para detectar T. cruzi, como la cardiopatía crónica endémica rural no chagásica, común en Venezuela. En México y otros países es común encontrar como causa de muerte la "miocardiopatía idiopática" cuando no se encuentra La etiología de la misma. Se presenta el caso de un hombre de 26 años que murió por miocardiopatía dilatada secundaria a leptospirosis. CtInicamente, además de la falla cardiaca destacaban ictericia, hiperbilirrubinemia, elevación de transaminasas, hematuria y proteinuria. Inicialmente se había sospechado miocardiopatía chagásica, pero los antecedentes epidemiológicos y las pruebas parasitológicas y serológicas para T. cruzi fueron negativos. Se le practicó videograbación en microscopia de campo oscuro en sangre y orina, impregnación argéntica, inmunohistoquímica y hemocultivo en meclio EMJH, positivos todos a leptospirosis. El cuttivo fue positivo a L. interrogans serovariedad Pomona. Postmortem se confirmó la detección de leptospira en tejidos mediante histopatología, impregnación argéntica, inmunofluorescencia indirecta e inmunohistoquímica. [ABSTRACT FROM AUTHOR]
    • 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, proteinuna 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. [ABSTRACT FROM AUTHOR]
    • Abstract:
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