Pericarditis and Perimyocarditis Associated with Active Mycoplasma pneumoniae Infection

Abstract

In 13 patients an association existed from 1970-73 between Mycoplasma pneumoniae infection and acute pericarditis (in eight) or perimyocarditis (in five). In 12 patients the association was moderately probable, with a fourfold rise in complement-fixing antibody titers between acute and convalescent phase sera being noted. In the last patient, a lesser-order association was found using only convalsecent phase serum. The presence of influenza, herpes simplex, Coxsackie B, or adenovirus was excluded by serologic testing. Acute illness was variable, with four patients developing heart failure. Long-term evaluation (mean, 47 months) found eight patients asymptomatic and three symptomatic. Two patients died. Residual effects of the Mycoplasma infection seemed at least partially responsible in one compromised patient and in one who died. Mycoplasma infection should be considered in the presence of acute cardiovascular decompensation, especially when preceded by upper respiratory infection, and added to the possible causes of idiopathic cardiomyopathy.

Pathogenesis of extrapulmonary manifestations of Mycoplasma pneumoniae infection with special reference to pneumonia

“…Presently autoimmunity is the most likely explanation [6,8]. The overlapping disease, perimyocarditis, also has an unknown pathomechanism [6,7]. It might occur when inflammation of the pericardium spreads over the myocardium, or vice versa.…”

“…Cardiac manifestations are among the most frequently reported extrapulmonary manifestations; excellent reviews of the conditions in this category were already being published as early as the 1970s [6,7]. Since they first came under study, it has been believed that multiple etiologies are involved in the pathomechanism of cardiac manifestations [6,8].…”

Constrictive pericarditis secondary to infection with Mycoplasma pneumoniae

“…PCR nucleic acid amplification now provides highly sensitive and specific diagnosis of M. pneumoniae from bodily fluids and tissues [20,21]. Cardiovascular involvement was reported in 12 of 141 adult patients with serologic evidence of M. pneumoniae [22]. Levy et al…”

A Case of Acute Myopericarditis Associated with Mycoplasma pneumoniae Infection in a Korean Adult

“…pneumoniae infection can also present with extrapulmonary manifestations such as skin lesions, gastrointestinal or neurologic symptoms, as well as cardiac involvement (2). Cardiac involvement, such as acute myocarditis, pericarditis or myopericarditis, is an infrequent manifestation of M. pneumoniae (2)(3)(4)(5).…”

“…pneumoniae infection can also present with extrapulmonary manifestations such as skin lesions, gastrointestinal or neurologic symptoms, as well as cardiac involvement (2). Cardiac involvement, such as acute myocarditis, pericarditis or myopericarditis, is an infrequent manifestation of M. pneumoniae (2)(3)(4)(5). In 1979, a review reported by Ponka found that only 58 cases of carditis associated with M. pneumoniae infection had been reported in medical literature (4 (8)(9)(10).…”