Myocarditis Triggered by Erysipelas: A Rare Infectious Complication
Katharina Wosgien1, Darach O H-Ici1
1Department of Cardiology and Internal Intensive Care Medicine, Vivantes Friedrichshain Berlin, Berlin, Germany.
JACC. Case Reports
|August 1, 2025
Summary
Group A Streptococcus can cause toxin-mediated myocarditis, a rare heart inflammation. Early recognition and cardiac MRI are crucial for diagnosing and managing this serious bacterial infection.
Area of Science:
- Cardiology
- Infectious Diseases
- Toxicology
Background:
- Myocarditis, an inflammation of the heart muscle, is typically viral but can stem from bacterial infections.
- Group A β-hemolytic Streptococcus is an uncommon yet significant bacterial cause of myocarditis.
Observation:
- A 26-year-old male presented with chest pain following erysipelas, a skin infection caused by Streptococcus.
- Initial ECG and echocardiography suggested myocardial injury, while cardiac MRI confirmed myocarditis.
- Elevated antistreptolysin O titers confirmed a recent streptococcal infection.
Findings:
- The case demonstrates toxin-mediated myocarditis secondary to erysipelas.
- Nonrheumatic bacterial myocarditis, though rare, requires prompt diagnosis and treatment.
- Cardiac magnetic resonance imaging (CMR) is vital for accurate diagnosis and management.
Implications:
- This case underscores the importance of considering bacterial causes, particularly Streptococcus, in myocarditis presentations.
- Prompt identification of bacterial triggers like Streptococcus is essential for effective treatment.
- Advanced imaging like CMR plays a critical role in diagnosing and managing complex myocarditis cases.
Keywords:
blood testscardiac magnetic resonancechest paincomplicationfibrosisimagingleft ventriclenecrosisMore Related Videos
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