Prevalence of cardiac dysfunction in patients with acute febrile illness with shock admitted in intensive care unit

Patients with AFI (acute febrile illness) often present with sepsis, and progression to multi-organ dysfunction ensues.[1] In tropical climate AFI is one of the most usual presentation we encounter during and after the monsoon season.[2] AFI is defined as fever ≥ 38 °C and < 15 days duration without a localized source of infection.[3] Dengue fever, scrub typhus and leptospirosis are common AFIs in our region, and if severe, these are associated with significant morbidity and mortality leading to multi-organ dysfunction syndrome (MODS).[4] The frequency and extent of cardiac involvement in leptospirosis and other tropical fevers, are under-reported and poorly understood. Leptospirosis associated myocardial dysfunction is equivocal and the pattern of cardiac involvement may not differ from that of sepsis associated myocarditis.[5] This study aims to look at the prevalence of cardiac dysfunction in patients admitted with acute febrile illness admitted to intensive care unit.

References:

1. Yilmaz H, Turhan V, Yasar KK, Hatipoglu M, Sunbul M, Leblebicioglu H. Characteristics of leptospirosis with systemic inflammatory response syndrome: a multicenter study. Ann Clin Microbiol Antimicrob. 2015 Dec 21;14:54. doi: 10.1186/s12941-015-0117-x. PMID: 26690093; PMCID: PMC4687284.

2.  Wangdi, K., Kasturiaratchi, K., Nery SV, Lau CL, Gray DJ, Clements ACA. Diversity of infectious aetiologies of acute undifferentiated febrile illnesses in south and Southeast Asia: a systematic review. BMC Infect Dis 19, 577 (2019). https://doi.org/10.1186/s12879-019-4185-y.

3. Bhaskaran, D., Chadha, S.S., Sarin, S. et al. Diagnostic tools used in the evaluation of acute febrile illness in South India: a scoping review. BMC Infect Dis 19, 970 (2019). https://doi.org/10.1186/s12879-019-4589-8.

4. Ray A, Mohta S, Soneja M, Jadon R, Wig N, Sood R. Clinical spectrum and outcome of critically ill hospitalized patients with acute febrile illness and new-onset organ dysfunction presenting during monsoon season. Drug Discov Ther. 2019;13(2):101-107. doi: 10.5582/ddt.2019.01023.

5. Caforio ALP, Pankuweit S, Arbustini E, et al. Current state of knowledge on aetiology, diagnosis, management, and therapy of myocarditis: A position statement of the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases. Eur Heart J 2013; 34: 2636–2648, 2648a–2648d.