Leptospirosis Complicated by Haemorrhagic Cardiac Tamponade: A Challenging Case of Weil's Disease

Leptospirosis is a bacterial infection with a worldwide distribution. It is most commonly transmitted through exposure to water contaminated with the urine of infected rodents. It is a biphasic illness consisting of an initial acute febrile phase lasting up to seven days, followed by a second immune phase with symptoms of organ involvement and widespread vasculitis lasting up to 30 days. Cardiac involvement, including arrhythmias and myopericarditis, is a recognised complication of leptospirosis. However, we present a case of haemorrhagic cardiac tamponade causing cardiac arrest, occurring 10 days after admission. This direct association is rarely reported. We hope to raise awareness to enable prompt recognition of this rare but serious complication. In addition, we feel that echocardiography during the immune phase of severe disease has the potential to improve outcomes.