Cunningham Christy, Lee Christine H
Department of Pathology and Molecular Medicine, McMaster University, St Joseph's Healthcare, 50 Charlton Avenue East, Hamilton, Ontario, L8N 4A6, Canada.
BMC Infect Dis. 2003 Jul 17;3:16. doi: 10.1186/1471-2334-3-16.
Myocarditis can develop as a complication of various infections and is most commonly linked to enterovirus infections. Myocarditis is rarely associated with bacterial infections; salmonellosis and shigellosis have been the most frequently reported bacterial cause. We report a case of myocarditis related to Campylobacter jejuni enteritis.
A 30-year-old previously healthy man presented with a history of prolonged chest pain radiating to the jaw and the left arm. Five days prior to the onset of chest pain, he developed bloody diarrhea, fever and chills. Creatine kinase (CK) and CK-MB were elevated to 289 U/L and 28.7 microg/L. Troponin I was 30.2 microg/L. The electrocardiogram (ECG) showed T wave inversion in the lateral and inferior leads. The chest pain resolved within 24 hours of admission. The patient had a completely normal ECG stress test. The patient was initiated on ciprofloxacin 500 mg po bid when Campylobacter jejuni was isolated from the stool. Diarrhea resolved within 48 hours of initiation of ciprofloxacin. The diagnosis of Campylobacter enteritis and related myocarditis was made based on the clinical and laboratory results and the patient was discharged from the hospital in stable condition.
Myocarditis can be a rare but severe complication of infectious disease and should be considered as a diagnosis in patients presenting with chest pain and elevated cardiac enzymes in the absence of underlying coronary disease. It can lead to cardiomyopathy and congestive heart failure. There are only a few reported cases of myocarditis associated with Campylobacter infection.
心肌炎可作为各种感染的并发症出现,最常见与肠道病毒感染有关。心肌炎很少与细菌感染相关;沙门氏菌病和志贺氏菌病是最常报告的细菌病因。我们报告一例与空肠弯曲菌肠炎相关的心肌炎病例。
一名30岁既往健康男性,出现放射至下颌和左臂的长时间胸痛病史。在胸痛发作前5天,他出现了血性腹泻、发热和寒战。肌酸激酶(CK)和肌酸激酶同工酶(CK-MB)分别升高至289 U/L和28.7 μg/L。肌钙蛋白I为30.2 μg/L。心电图(ECG)显示侧壁和下壁导联T波倒置。胸痛在入院后24小时内缓解。患者的心电图负荷试验完全正常。当从粪便中分离出空肠弯曲菌时,患者开始口服环丙沙星500 mg,每日两次。腹泻在开始使用环丙沙星后48小时内缓解。根据临床和实验室结果诊断为空肠弯曲菌肠炎及相关心肌炎,患者病情稳定后出院。
心肌炎可能是一种罕见但严重的传染病并发症,对于无潜在冠心病但出现胸痛和心肌酶升高的患者应考虑诊断为心肌炎。它可导致心肌病和充血性心力衰竭。仅有少数关于空肠弯曲菌感染相关心肌炎的报道病例。