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From gut to heart: Salmonella gastroenteritis complicated by myocarditis: a case report
Orestis Paschalis1, Paul Njoku2, Amit K J Mandal2
1School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom.
Abstract:
Acute myocarditis is an inflammatory condition of the heart muscle, most commonly caused by viral infections. Bacterial myocarditis, particularly due to non-typhoidal Salmonella (NTS), is exceptionally uncommon in immunocompetent individuals. We report a rare case of acute myocarditis secondary to Salmonella gastroenteritis in a woman in her early 20s, characterised by elevated cardiac biomarkers, positive stool cultures for Salmonella enterica, electrocardiographic changes and confirmatory cardiac magnetic resonance imaging. Management was conservative with anti-inflammatory monotherapy without antibiotic treatment, resulting in full clinical recovery with resolution of symptoms and normalisation of cardiac biomarkers. This case highlights a rare presentation of NTS-associated myocarditis and suggests that conservative management may be sufficient in selected cases. It underscores the importance of considering bacterial pathogens, including NTS, in the differential diagnosis of acute myocarditis, even in immunocompetent patients, and highlights the utility of multimodal imaging and individualised management strategies in achieving favourable outcomes in bacterial myocarditis.
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