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Mycoplasma-associated carditis. Case reports and review
1Infectious Diseases Unit, Bnai Zion Medical Center and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
Abstract:
We present 2 cases and examine the developments that occurred in diagnosis, treatment, and outcome of 19 additional patients with mycoplasmal peri- and myocarditis. The mean age of this group was 33 years. The final diagnoses were pericarditis (n = 15), myocarditis (n = 5), and myopericarditis (n = 1); pulmonary involvement was noted in 13 patients. Serology established the diagnosis in 12 cases, and isolation in 9 others. In contrast to previous reviews, an echocardiogram was carried out in all patients, thus enabling pericardiocentesis in 13 patients. Antibiotics were given to 19 patients, including 4 who received a newer macrolide. Three patients were left with long-term sequelae, and 1 patient died. The outcome of Mycoplasma carditis has improved over the years, although a minority of patients may suffer long-term sequelae.
Insights
Mycoplasma infections can cause serious heart inflammation (myocarditis) and surrounding sac inflammation (pericarditis). While outcomes have improved with modern treatments like echocardiograms and antibiotics, some patients still experience long-term complications.
Area of Science:
- Cardiology
- Infectious Diseases
- Internal Medicine
Background:
- Mycoplasmal peri- and myocarditis are rare but serious infections affecting the heart.
- Previous reviews lack comprehensive data on modern diagnostic and treatment approaches.
Observation:
- A study of 21 patients (mean age 33) with Mycoplasma carditis, including pericarditis, myocarditis, and myopericarditis.
- Pulmonary involvement was noted in 13 patients.
- Echocardiography was performed in all patients, aiding diagnosis and guiding pericardiocentesis in 13 cases.
Findings:
- Diagnosis was established via serology (12 cases) and isolation (9 cases).
- Nineteen patients received antibiotics, with 4 treated using newer macrolides.
- Three patients experienced long-term sequelae, and one patient died.
Implications:
- The outcome of Mycoplasma carditis has improved significantly over time.
- Despite advances, a minority of patients may still develop long-term health issues.
- This study highlights the importance of echocardiography and timely antibiotic treatment in managing Mycoplasma carditis.