Paroxysmal atrial fibrillation: an unusual association of leptospirosis

A 60 year old nonsmoker, non-diabetic, normotensive farmer presented with 4 days history of fever, myalgia & headache. He had relative bradycardia, eye congestion, diffuse muscle tenderness and tender hepatomegaly at presentation. He developed subconjunctival hemorrhage on 3rd in-hospital day. His investigations showed thrombocytopenia, hepatic and renal dysfunctions. His leptospira serology was positive. He was treated with injection crystalline penicillin and supportive therapy. While on treatment, even though he did not have any known cardiac risk factors, except for his age & gender, he developed 3 paroxysms of atrial fibrillation on 5th - 7th in-hospital days, without hemodynamic instability. His cardiac markers and echocardiogram during the paroxysms were otherwise normal. He had uneventful recovery, remained in sinus rhythm and stable at follow-up. This paroxysmal atrial fibrillation may be a coincidence or attributed as unusual association of leptospirosis.