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Delayed presentation of biopsy-proven eosinophilic myocarditis following COVID-19 mRNA vaccine

Chaitra Janga1, Tirth Patel1, Hussam Al Hennawi1

  • 1Department of Internal Medicine, Jefferson Abington Hospital, Abington, PA, USA.

Global Cardiology Science & Practice
|June 23, 2023
PubMed

Insights

Delayed eosinophilic myocarditis, a rare hypersensitivity reaction, can occur after COVID-19 mRNA vaccination. This case highlights a potential delayed presentation of this vaccine adverse event.

Area of Science:

  • Cardiology
  • Immunology
  • Vaccinology

Background:

  • Myopericarditis is an uncommon adverse reaction associated with COVID-19 mRNA vaccines, particularly in young males.
  • Eosinophilic myocarditis, a rare subtype of myocarditis, involves myocardial eosinophilic infiltrates and can be a hypersensitivity reaction to drugs or vaccines.
  • Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) syndrome may accompany eosinophilic myocarditis, which rarely involves myocyte necrosis or fibrosis.

Observation:

  • A case report details a 24-year-old male experiencing biopsy-proven eosinophilic myocarditis.
  • The patient's condition was likely a delayed adverse reaction following COVID-19 mRNA vaccination.

Findings:

  • This case represents the first reported instance of delayed eosinophilic myocarditis post-COVID-19 mRNA vaccination.
  • The patient presented with characteristic eosinophilic myocardial infiltrates.

Implications:

  • Clinicians should consider the possibility of delayed eosinophilic myocarditis as a vaccine adverse event.
  • Awareness of delayed presentations is crucial for timely diagnosis and management to prevent associated morbidity.

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