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Published on: March 10, 2020
Myocarditis in a Pediatric Patient with Campylobacter Enteritis: A Case Report and Literature Review
Anastasios-Panagiotis Chantzaras1, Spyridon Karageorgos1, Panagiota Panagiotou1
1First Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, "Aghia Sophia" Children's Hospital, Thivon and Papadiamantopoulou Street, 11527 Athens, Greece.
Insights
Campylobacter infection can cause myocarditis (inflammation of the heart muscle), particularly in adolescents. Early suspicion is crucial for prompt diagnosis and treatment of this rare but serious complication.
Area of Science:
- Cardiology
- Infectious Diseases
- Pediatrics
Background:
- Myocarditis is a challenging diagnosis, often linked to infections.
- Data on Campylobacter-associated myocarditis, especially in children, is scarce.
Observation:
- A case study of a 13-year-old female with Campylobacter jejuni gastroenteritis and subsequent myocarditis.
- A literature review identified 7 pediatric cases of Campylobacter-associated carditis over 20 years.
Findings:
- Most affected patients were male (6/7), with a mean age of 16.1 years.
- Common symptoms included gastrointestinal issues followed by chest pain within days.
- Campylobacter was confirmed in stool samples, with abnormal ECG (6/7) and echocardiogram (3/7) findings.
Implications:
- Highlights the need for high clinical suspicion of myocarditis in pediatric patients with recent infections presenting with chest pain.
- Early diagnosis and treatment, including antibiotics, can lead to full recovery in most cases.
- This emphasizes the importance of considering infectious etiologies for pediatric myocarditis.
Abstract:
Myocarditis represents a potential complication of various infectious and noninfectious agents and a common diagnostic challenge for clinicians. Data regarding Campylobacter-associated myocarditis are limited. Here, a case of a 13-year-old female with Campylobacter jejuni gastroenteritis complicated by myocarditis is presented, followed by a literature review in order to retrieve information about Campylobacter-associated carditis in the pediatric population. A search on MEDLINE/PubMed yielded 7relevant cases in the last 20 years. Most of them (six/seven) were males and the mean age was 16.1 years. All patients presented with gastrointestinal symptoms followed in six/seven cases by chest pain within two to seven days. Campylobacter was isolated from stool cultures in six patients; abnormal electrocardiographic findings were detected in six; and abnormal echocardiographic findings in three of the cases. Five patients were treated with antibiotics. Full recovery was the clinical outcome in six patients, whereas one patient died. Concerning the nonspecific symptoms of patients with myocarditis, high clinical suspicion of this complication is necessary in cases where patients with a recent infection present with chest pain and elevated cardiac biomarkers.
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