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Published on: February 23, 2024
Campylobacter jejuni-Associated Perimyocarditis in 53-Year-Old Male With Chest Pain and Watery Diarrhea
Jacob Alexander1, Jatinchandra Patel2, Aaron VanHise2
1University of New England College of Osteopathic Medicine, Biddeford, Maine, USA.
Background:
Perimyocarditis is characterized by concurrent inflammation of the myocardium and pericardial sac. Multiple atypical etiologies may induce perimyocarditis.
Case Summary:
A 53-year-old man presented with pleuritic chest pain and 2 days of preceding watery diarrhea. Work-up revealed elevated troponins and elevated inflammatory markers, ST-segment elevations on electrocardiogram, and a nonobstructive coronary angiogram. Echocardiogram showed reduced left ventricular ejection fraction. Stool cultures positive for Campylobacter jejuni supported a diagnosis of C jejuni-associated perimyocarditis. Treatment included colchicine, guideline-directed medical therapy for heart failure, and levofloxacin.
Discussion:
This case provides insights into the diagnostic and therapeutic challenges and a process for diagnosing perimyocarditis due to an atypical pathogen, such as C jejuni.
Take-Home Messages:
After excluding acute coronary syndrome, history taking and expanding the differential diagnosis of chest pain helps uncover etiology and targeted therapy. When cardiac magnetic resonance is unavailable, clinicians must use other modalities to support diagnosis and guide management.
Insights
Campylobacter jejuni can cause perimyocarditis, an inflammation of the heart muscle and surrounding sac. Early diagnosis and targeted antibiotic therapy are crucial for managing this rare condition.
Area of Science:
- Cardiology
- Infectious Diseases
- Internal Medicine
Background:
- Perimyocarditis involves inflammation of both the myocardium and pericardial sac.
- Atypical pathogens can trigger perimyocarditis, presenting diagnostic challenges.
Related Concept Videos
Endocarditis I: Introduction
Myocarditis I: Introduction
Pericarditis I: Introduction
Endocarditis II: Clinical Features of Infective Endocarditis
Myocarditis II: Clinical Features and Diagnostic Tests
Endocarditis III: Medical Management

