Boy treated for rare case of leptospiral endocarditis

A 14-year old boy, suffering from a very rare case of Leptospiral Endocarditis resulting in sudden stroke, was saved by the doctors of a city hospital.
The boy, studying in 9th standard and son of a doctor, who had complaint of difficulty in speaking and weakness on one half of the body, was admitted to K G Hospital a few days ago, Dr G Bhakthavatsalam, Chairman of the hospital, said in a release here.
He used to suddenly become hemiplegic - paralysis of one half of the body along with speech difficulty, which created problems for the family. Dr T C R Ramakrishnan, the Chief Neurologist of the hospital carried out CT and MRI scans and found that there were early ischemic changes in the boy's brain.

The routine protocol was to do thrombolysis of clot busting activity, using a drug.
However, chief cardiologist in the hospital, who examined the heart for the possible clot in the heart, since damage of the brain vessels by the clot was a common cause of sudden stroke in the young, found vegetaions in the aortic heart valve, he said.
The patient was put on powerful antibiotics and was kept in the ICU for ten days and repeat echo cardiography showed further growth of vegetations.

As repeated blood cultures yielded negative results, microbiologist performed ELISA for Leptospiral IgM antibodies, which came as positive and it was diagnosed as a very rare case of Leptospiral Endocarditis, Bhakthavatsalam said.

Only two cases have been published so far in the world literature, he claimed.
Leptospirosis is a globally important zoonotic disease caused by spirochetes of the genus Leptospira.
Sources of transmission to humans include rats, dogs, cattle and pigs and mode of transmission could be Indirect contact with contaminated animal urine through surface waters, moist soil or other wet environments, direct contact with urine and other excreta of infected animals.
The organism infects the mucosa (conjunctival, oral or tonsillar) or enters through macerated, punctured or abraded skin and in case of the boy, indirect mode of transmission could be implicated, Bhakthavatsalam said.