TY - JOUR
T1 - Chest pain and diarrhea
T2 - A case of campylobacter jejuni-associated myocarditis
AU - Panikkath, Ragesh
AU - Costilla, Vanessa
AU - Hoang, Priscilla
AU - Wood, Joseph
AU - Gruden, James F.
AU - Dietrich, Bob
AU - Gotway, Michael B.
AU - Appleton, Christopher
PY - 2014/2
Y1 - 2014/2
N2 - Background Diarrhea and chest pain are common symptoms in patients presenting to the emergency department (ED). However, rarely is a relationship between these two symptoms established in a single patient. Objective Describe a case of Campylobacter-associated myocarditis. Case Report A 43-year-old man with a history of hypertension presented to the ED with angina-like chest pain and a 3-day history of diarrhea. Electrocardiogram revealed ST-segment elevation in the lateral leads. Coronary angiogram revealed no obstructive coronary artery disease. Troponin T rose to 1.75 ng/mL. Cardiac magnetic resonance imaging showed subepicardial and mid-myocardial enhancement, particularly in the anterolateral wall and interventricular septum, consistent with a diagnosis of myocarditis. Stool studies were positive for Campylobacter jejuni. Conclusions Campylobacter-associated myocarditis is rare, but performing the appropriate initial diagnostic testing, including stool cultures, is critical to making the diagnosis. Identifying the etiology of myocarditis as bacterial will ensure that appropriate treatment with antibiotics occurs in addition to any cardiology medications needed for supportive care.
AB - Background Diarrhea and chest pain are common symptoms in patients presenting to the emergency department (ED). However, rarely is a relationship between these two symptoms established in a single patient. Objective Describe a case of Campylobacter-associated myocarditis. Case Report A 43-year-old man with a history of hypertension presented to the ED with angina-like chest pain and a 3-day history of diarrhea. Electrocardiogram revealed ST-segment elevation in the lateral leads. Coronary angiogram revealed no obstructive coronary artery disease. Troponin T rose to 1.75 ng/mL. Cardiac magnetic resonance imaging showed subepicardial and mid-myocardial enhancement, particularly in the anterolateral wall and interventricular septum, consistent with a diagnosis of myocarditis. Stool studies were positive for Campylobacter jejuni. Conclusions Campylobacter-associated myocarditis is rare, but performing the appropriate initial diagnostic testing, including stool cultures, is critical to making the diagnosis. Identifying the etiology of myocarditis as bacterial will ensure that appropriate treatment with antibiotics occurs in addition to any cardiology medications needed for supportive care.
KW - Campylobacter jejuni
KW - diarrhea
KW - myocarditis
KW - myopericarditis
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U2 - 10.1016/j.jemermed.2013.08.060
DO - 10.1016/j.jemermed.2013.08.060
M3 - Article
C2 - 24188611
AN - SCOPUS:84892984183
SN - 0736-4679
VL - 46
SP - 180
EP - 183
JO - Journal of Emergency Medicine
JF - Journal of Emergency Medicine
IS - 2
ER -