Severe leptospirosis complicated with atrial fibrillation

Cardiac rhythm abnormality is a common finding in patients with leptospirosis. Relative bradycardia, atrial fibrillation, atrial flutter and ventricular premature beats are the common arrhythmias seen in leptospirosis. In the present case, the patient presented with septic shock and had atrial fibrillation. Further evaluation revealed hypokalemic acute kidney injury and severe metabolic acidosis. The atrial fibrillation reverted to sinus rhythm after correction of hypokalemia, acidosis, septic shock and with medical cardioversion. This case revealed that early detection of rhythm abnormalities and other forms of cardiac involvement and correction of precipitating factors is important in preventing fatal outcomes in leptospirosis.