Spighi Lorenzo, Broccatelli Andrea, Notaristefano Francesco, Verdecchia Paolo, Ambrosio Giuseppe, Cavallini Claudio
S.C. Cardiologia e Fisiopatologia Cardiovascolare.
S.C. Cardiologia, Ospedale Santa Maria della Misericordia, Perugia.
G Ital Cardiol (Rome). 2020 Mar;21(3):224-227. doi: 10.1714/3306.32771.
We report a case of acute myocarditis associated with pericarditis in a patient hospitalized for urinary tract infection due to Escherichia coli. To the best of our knowledge, there are no prior descriptions of acute myocarditis associated with pericarditis during Escherichia coli infections in the absence of sepsis. In our patient, myocardial damage has been accurately documented by electrocardiography, echocardiography and magnetic resonance imaging. Inclusion of magnetic resonance imaging allows detection of myocardial inflammatory lesions that otherwise would have remained undiagnosed. The basic mechanisms of myocardial damage during Escherichia coli infection are unclear. Endotoxins might cause inflammatory reactions in the myocardium leading to myocyte damage. After initiation of antibiotic therapy, there was a rapid improvement of contractile function, with concomitant normalization of clinical and biochemical abnormalities. We discussed our findings in the context of the limited information available from the literature.
我们报告了一例因大肠杆菌引起的尿路感染而住院的患者,该患者患有急性心肌炎合并心包炎。据我们所知,此前尚无关于在无脓毒症的大肠杆菌感染期间发生急性心肌炎合并心包炎的描述。在我们的患者中,通过心电图、超声心动图及磁共振成像准确记录了心肌损伤情况。纳入磁共振成像可检测到原本会未被诊断出的心肌炎性病变。大肠杆菌感染期间心肌损伤的基本机制尚不清楚。内毒素可能会在心肌中引发炎症反应,导致心肌细胞损伤。开始抗生素治疗后,收缩功能迅速改善,同时临床及生化异常情况也恢复正常。我们结合文献中有限的可用信息对我们的研究结果进行了讨论。