Villablanca Pedro, Mohananey Divyanshu, Meier Garnet, Yap John E, Chouksey Sonam, Abegunde Ayokunle T
Pedro Villablanca, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY 10467, United States.
World J Cardiol. 2015 Dec 26;7(12):931-7. doi: 10.4330/wjc.v7.i12.931.
To study trends in the epidemiology, clinical presentation, microbiology and prognosis of non-typhoid Salmonella (NTS) myocarditis.
We performed a systematic literature search for all reported NTS cases. The search yielded 838 publications. A total of 21 papers were deemed eligible. No language restrictions were enforced. Articles that were not written in English were translated. Pre-specified data such as clinical presentation, electrocardiogram (ECG) changes, transthoracic echocardiographic findings, cardiac magnetic resonance findings, microbiology cultures, Salmonella species, inflammatory markers (erythrocyte sedimentation rate and C-reactive protein), cardiac biomarkers and severity of illness were collected using data extraction sheets. Cases were classified by age into 2 groups; pediatric cases (defined as < 18 years old) and adult cases (defined ≥ 18 years old). The mean age of patients and standard deviations were calculated. The data was analyzed with IBM SPSS Statistics (Windows, Version 20.0. Armonk, NY: IBM Corp.) for demographic characteristics, presenting symptoms, microbiology, diagnostic methods, treatment modalities and outcome.
From the selected articles, we identified a total of 24 individual cases with verifiable data. There were 20 males with a male to female ratio of 5:1. The mean age at presentation was 30.8 years (range 1 mo-67 years), 16% of cases were children aged < 18 years. Most patients presented with chest pain, fever, and abdominal pain. The most common ECG finding was ST elevation. Cardiac biomarkers were elevated in around 70% of cases. Salmonella Enteritidis was the most common NTS isolated. Definitive diagnosis was established by blood and stool cultures in most of the cases. The pediatric and adults cases had similar incidence of bacteremia (40% vs 36.8%) while the pediatric group had more stool cultures positive compared to the adult group (100% vs 63.1%). Eighty-three percent of patients received antibiotics and 58% were successfully treated through conservative management. The overall mortality was 24% and 42% of patients required intensive care.
This systematic review of published cases shows that NTS myocarditis occurs predominantly in young adults and carries a poor prognosis.
研究非伤寒沙门菌（NTS）心肌炎的流行病学、临床表现、微生物学及预后趋势。
我们对所有已报道的NTS病例进行了系统的文献检索。检索共得到838篇出版物。共有21篇论文被认为符合要求。未实施语言限制。非英文撰写的文章进行了翻译。使用数据提取表收集预先指定的数据，如临床表现、心电图（ECG）变化、经胸超声心动图检查结果、心脏磁共振检查结果、微生物培养、沙门菌种类、炎症标志物（红细胞沉降率和C反应蛋白）、心脏生物标志物及疾病严重程度。病例按年龄分为2组；儿科病例（定义为<18岁）和成人病例（定义为≥18岁）。计算患者的平均年龄和标准差。使用IBM SPSS Statistics（Windows，版本20.0。纽约州阿蒙克：IBM公司）对数据进行分析，以了解人口统计学特征、呈现症状、微生物学、诊断方法、治疗方式及结果。
从所选文章中，我们共确定了24例有可核实数据的个体病例。有20名男性，男女比例为5:1。就诊时的平均年龄为30.8岁（范围1个月 - 67岁），16%的病例为<18岁的儿童。大多数患者表现为胸痛、发热和腹痛。最常见的心电图表现是ST段抬高。约70%的病例心脏生物标志物升高。肠炎沙门菌是最常见的分离出的NTS。大多数病例通过血液和粪便培养确诊。儿科和成人病例的菌血症发生率相似（40%对36.8%），而儿科组粪便培养阳性的比例高于成人组（100%对63.1%）。83%的患者接受了抗生素治疗，58%的患者通过保守治疗成功治愈。总体死亡率为24%，42%的患者需要重症监护。
对已发表病例的这项系统评价表明，NTS心肌炎主要发生在年轻人中，预后较差。
