Myocarditis Triggered by Erysipelas: A Rare Infectious Complication

Myocarditis is an inflammatory disease of the myocardium often triggered by viral infections. However, bacterial causes, such as group A β-hemolytic Streptococcus, are less common but clinically significant.

A 26-year-old man presented with acute chest pain after erysipelas of the right foot. Electrocardiography revealed unspecific ST-segment elevations. Cardiac biomarkers were elevated, and transthoracic echocardiography showed global hypokinesia with a reduced ejection fraction. Cardiac magnetic resonance imaging confirmed myocarditis. Elevated antistreptolysin O titers indicated a recent streptococcal infection. The patient recovered fully after 7 days of intravenous antibiotics.

This case highlights toxin-mediated myocarditis secondary to erysipelas, a rare but significant clinical entity. The body of evidence on nonrheumatic bacterial myocarditis underscores the importance of early recognition and appropriate imaging.

Streptococcal infections can cause myocarditis through toxin-mediated mechanisms. Cardiac magnetic resonance imaging is essential for diagnosing myocarditis and guiding management.