A previously well 62-year-old male from North Queensland presented with leptospirosis featuring fever, renal failure, hepatitis and pulmonary haemorrhage. Management was greatly complicated by severe and previously unrecognized aortic stenosis with a peak valve gradient of 125mmHg. A successful outcome followed careful haemodynamic management and treatment of the infective illness with subsequent valve replacement.
SimpsonF.G., GreenK.A., HaugG.J., BrookesD.L.Leptospirosis associated with severe pulmonary haemorrhage in far north Queensland.Med J Aust1998; 169: 151–153.
3.
GregoireN., HigginsR., RobinsonY.Isolation of leptospires from nephritic kidneys of beef cattle at slaughter.Am J Vet Res1987; 48: 370–371.
4.
PinnT.G.Leptospirosis in the Seychelles.Med J Aust1992; 156: 163–167.
5.
AllenP., RafteryS., PhelanD.Massive pulmonary haemorrhage due to leptospirosis.Intensive Care Med1989; 15: 322–324.
ParkerM.M., ShelhamerJ.H., NatansonC., AllingD.W., ParrilloJ.E.Serial cardiovascular variables in survivors and non-survivors of human septic shock: Heart rate as an early predictor of prognosis.Crit Care Med1987; 15: 923–929.
8.
OttoC.M., BurwashI.G., LeggetM.E.. Prospective study of asymptomatic valvular aortic stenosis.Circulation1997; 95: 2262–2270.
9.
LiedtkeA.J., GentzlerR.D., BabbJ.D., HunterA.S., GaultJ.H.Determinants of cardiac performance in severe aortic stenosis.Chest1976; 69: 192–200.
10.
RyanT., Mc CarthyJ.F., RadyM.Y.. Early bloodstream infection after cardiopulmonary bypass: Frequency rate, risk factors, and implications.Crit Care Med1997; 25: 2009–2014.
11.
RoquesF., NashefS.A., MichelP.. Risk factors and outcome in European cardiac surgery: analysis of the EuroSCORE multinational database of 19030 patients.Eur J Cardiothorac Surg1999; 15: 816–822.
