Chlamydophila pneumoniae myopericarditis in a child
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Monnipa Suesaowalak1, Michele M Cheung, Dawn Tucker
1Pediatric Cardiac Surgery Foundation, Institute of Cardiovascular Disease, Rajvithi Hospital, Rajthevee, Bangkok, Thailand. smonnipa@hotmail.com
Insights
Chlamydophila pneumoniae infection can cause myopericarditis in children, a rare condition. Early diagnosis and treatment with azithromycin and IVIG led to a full recovery in an 11-year-old boy.
Area of Science:
- Pediatric Cardiology
- Infectious Diseases
- Cardiovascular Pathology
Background:
- Chlamydophila pneumoniae is a known pathogen, but its role in pediatric myopericarditis is not well-documented.
- Myopericarditis in children can present with diverse clinical manifestations and requires accurate etiological diagnosis.
Observation:
- An 11-year-old boy presented with symptoms of myopericarditis, including fever, rash, and constitutional symptoms.
- Laboratory findings revealed elevated acute phase reactants, cardiac enzymes, and brain natriuretic peptide.
- Echocardiography showed depressed left ventricular systolic function and pericardial effusion, with hemodynamic instability.
Findings:
- Serological tests confirmed Chlamydophila pneumoniae infection as the likely cause.
- The patient received azithromycin and intravenous immunoglobulin, along with inotropic support.
- Full recovery was achieved with improved cardiac function before hospital discharge.
Implications:
- This case highlights the importance of considering Chlamydophila pneumoniae in the differential diagnosis of pediatric myopericarditis.
- Early and specific diagnosis is crucial for effective management and improved prognosis in pediatric myocarditis.
- Targeted antimicrobial therapy may play a significant role in managing C. pneumoniae-induced myopericarditis.
Abstract:
An 11-year-old boy with serologically confirmed Chlamydophila pneumoniae infection presented with clinical, laboratory, and echocardiographic changes consistent with myopericarditis. No reports on C. pneumoniae myopericarditis in children are found in the medical literature. The boy, previously healthy, presented with fever, rash, constitutional symptoms, elevated acute phase reactants, elevated cardiac enzymes, and high brain natriuretic peptide levels. Hemodynamic instabilities, including hypotension and mild hypoxia, were noted. Two-dimensional echocardiographic findings showed mildly depressed left ventricular systolic function and small pericardial effusion. Requiring inotropic support, the boy was treated with azithromycin 10 mg/kg once daily for 7 days and a single dose of intravenous immunoglobulin 2 g/kg. He recovered fully with improved left ventricular systolic function before hospital discharge. An early definitive diagnosis is essential to knowing the etiology of pediatric myocarditis. Specific therapy may play role in the management and prognosis of this disorder.
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