ACUTE LEPTOSPIRA POMONA ARTHRITIS AND MYOCARDITIS

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Abstract
A case of leptospirosis due to L. pomona was described that resembled rheumatic fever and was associated with an unusual degree of myocarditis. Conjunctivitis patchy erythema of the trunk, headache, nausea, and vomiting suggested a systemic infection such as leptospirosis, but history of migrating joint pains, swelling and redness of one joint, and dyspnea, diffuse pulmonary densities suggesting comgestion and cardiac enlargement, as well as improvement following salicylate therapy, were consistent with a diagnosis of rheumatic fever. Agglutination tests for L. pomona showed a rise of titers to 1:4096 on the 14th and 21st days of illness. Antistreptolysin titers of the patients''s serum were low on the 8th, 35th, and 49th days of illness. The recognition of leptospirosis in the U. S. may be lagging behind the actual occurrence of the disease because of a too narrow conception of the clinical manifestations and a too narrow conception of the number of immunologically distinct strains of leptospirae. Appropriate agglutination and culture methods in atypical cases of acute infections may disclose other new syndromes due to various strains of leptospirae.

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