[Sudden cardiac death 43 months after fulminant myocarditis and two-peaked myositis in non-typhoid salmonellosis].

HISTORY AND CLINICAL FINDINGS

A previously healthy 29-year-old male was hospitalized due to acute myalgia and high temperature following an uncomplicated gastroenteritis. Within 24 hours, he developed life-threatening hemodynamic shock with the need for inotropic support and sustained ventricular tachycardia.

INVESTIGATIONS

Echocardiography and electrocardiogram as well as lab tests were consistent with the diagnosis of fulminant myocarditis and acute myositis. Serological and bacteriological analysis yielded an acute infection with salmonella D.

TREATMENT AND COURSE

The patient's condition stabilized under conservative supportive care within a few days. Apart from a histologically confirmed recurrent myositis four weeks later, no further complications occurred and the patient was clinically and echocardiographically considered to be in complete functional remission. Three and a half years later, however, the patient unexpectedly and suddenly died.

CONCLUSIONS

Although fulminant myocarditis is a life-threatening condition in its initial phase, the prognosis after recovery is considered to be good. However, this case study suggests that sudden cardiac death as a late complication of fulminant myocarditis may occur.