A case of myopericarditis associated to Campylobacter jejuni infection in the southern hemisphere

Abstract

Myopericarditis is an infrequent complication of acute diarrheal illness due to Campylobacter jejuni, and it has been mainly reported in developed nations. The first case detected in Chile--an upper-middle income country--that is coincidental with the increasing importance of acute gastroenteritis associated to this pathogen, is described. Recognition of this agent in stools requires special laboratory techniques not widely available, and it was suspected when a young patient presented with acute diarrhea, fever, and chest pain combined with electrocardiogram (EKG) abnormalities and elevated myocardial enzymes. C. jejuni myopericarditis can easily be suspected but its detection requires dedicated laboratory techniques.

Relapse of acute myocarditis associated with Campylobacter jejuni enterocolitis

“…1,2 In most cases, acute myocarditis associated with C jejuni develops approximately 1 week after the onset of enterocolitis. [2][3][4][6][7][8][9] Although most patients have a good prognosis, the early detection of C jejuni, early diagnosis of acute myocarditis, and early commencement of treatment are essential, as some cases are fatal or have residual permanent cardiac damage. 3 When patients present with chest pain or chest tightness with a recent history of enterocolitis, physicians must consider acute myocarditis as a differential diagnosis.…”

“…However, there is no available evidence regarding the appropriate dosage, treatment duration, or pharmacological efficacy. 2,4,5,7,9,12 Furthermore, the emergence of quinolone-resistant strains of C jejuni has become a global problem. 1 Acute myocarditis associated with C jejuni infection is also treated with medications that are routinely used to treat heart failure, such as diuretics, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, or β-blockers, with the aim of protecting the myocardium and providing symptomatic treatment, just as in other forms of myocarditis caused by more common pathogens such as viruses.…”

“…Campylobacter infection is a well‐known cause of enterocolitis that can be complicated with acute myocarditis 1,2 . In most cases, acute myocarditis associated with C jejuni develops approximately 1 week after the onset of enterocolitis 2‐4,6‐9 . Although most patients have a good prognosis, the early detection of C jejuni , early diagnosis of acute myocarditis, and early commencement of treatment are essential, as some cases are fatal or have residual permanent cardiac damage 3 .…”

“…Acute myocarditis associated with C jejuni infection is usually treated with antibiotics, especially ciprofloxacin or macrolide antibiotics, as well as conservative symptomatic treatment. However, there is no available evidence regarding the appropriate dosage, treatment duration, or pharmacological efficacy 2,4,5,7,9,12 . Furthermore, the emergence of quinolone‐resistant strains of C jejuni has become a global problem 1 .…”