[Transient cardiac failure due to infectious myocarditis]

Two men aged 19 (patient A) and 37 (patient B) years respectively, presented with symptoms of general malaise, fever and nonspecific ECG abnormalities. After admission both patients developed shock. Cardiac ultrasound revealed severe left ventricle dysfunction. On the basis of these findings, infectious myocarditis was suspected. Patient B was placed on artificial ventilation and haemodialysis due to respiratory and renal failure. Both patients were treated with inotropic drugs and antibiotics. Neisseria meningitidis was established as the cause of the myocarditis in patient A but in patient B no cause was found despite microbiological and autoimmune investigations. PCR tests and a biopsy of the myocardium were not performed. There was a satisfactory recovery in the left ventricle function of both patients during admission. These two cases illustrate that (infectious) myocarditis should be suspected in patients presenting with symptoms of general malaise, fever and nonspecific ECG abnormalities. If (infectious) myocarditis is diagnosed, the patient should be monitored for severe heart failure.