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Streptococcal tonsillitis and acute nonrheumatic myopericarditis.

J Karjalainen¹

¹Central Military Hospital, Helsinki, Finland.

|February 1, 1989

Summary

Streptococcal tonsillitis can cause acute myopericarditis, mimicking heart attacks. Early penicillin treatment in young adults with suspected streptococcal infections is crucial for good recovery from potential myocarditis.

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Area of Science:

Cardiology
Infectious Diseases
Rheumatology

Background:

Streptococcal tonsillitis is common in young adults.
Myopericarditis can present with symptoms similar to myocardial infarction.
The cardiac complications of streptococcal infections require further investigation.

Observation:

Two young men with streptococcal tonsillitis presented with acute myopericarditis.
A subsequent study screened 264 army conscripts with fever and sore throat for Group A Streptococcus.
Throat cultures identified Group A Streptococcus in 84 patients.

Findings:

Systematic screening using serial electrocardiography revealed one probable asymptomatic case of myocarditis among the 84 patients with Group A Streptococcus.
None of the patients exhibited signs of acute rheumatic fever.
All three identified patients with myocarditis received prompt penicillin therapy, leading to good recovery.

Implications:

This study highlights the importance of considering myopericarditis in patients with streptococcal tonsillitis, even when symptoms mimic myocardial infarction.
Systematic cardiac screening in specific populations with streptococcal pharyngitis may detect asymptomatic myocarditis.
Timely antibiotic treatment, such as penicillin, is effective in managing streptococcal-associated myopericarditis and ensuring favorable patient outcomes.

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