Junctional rhythm: A rare sign in leptospirosis
Leptospirosis is an important re-emerging infectious disease. Leptospirosis has been estimated to affect tens of millions of humans annually with a case fatality rate ranging from 5% to 25%; however, it is underreported due to the lack of clinical suspicion and barriers to diagnostic capacity.

The present case has been reported in the Indian Journal of Critical Care Medicine. A 33-year-old male presented with a history of fever, myalgia, severe bilateral calf pain, and headache of 2-day duration. He denied any history of recent travel.

His examination revealed icterus. His workup did not show any significant findings except for a mild transaminitis and a rise in serum creatinine by 0.5 mg/dl.

Later, the patient developed bradycardia. An ELISA test for Leptospira antibodies was positive. The patient recovered after a course of intravenous antibiotics.

Key takeaway:-
- This case had an atypical presentation with involvement of the cardiovascular system in the form of junctional rhythm.

- Leptospirosis should be considered early in the diagnosis of any patient who presents with acute, nonspecific febrile illness with multiorgan involvement.

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