TY - JOUR
T1 - Recurrent fulminant non-rheumatic streptococcal myocarditis proven by endomyocardial biopsy and autopsy
AU - Hiraiwa, Hiroaki
AU - Morimoto, Ryota
AU - Ando, Ryota
AU - Ito, Ryota
AU - Araki, Takashi
AU - Mizutani, Takashi
AU - Kazama, Shingo
AU - Kimura, Yuki
AU - Oishi, Hideo
AU - Kuwayama, Tasuku
AU - Yamaguchi, Shogo
AU - Kondo, Toru
AU - Okumura, Takahiro
AU - Enomoto, Atsushi
AU - Murohara, Toyoaki
N1 - Publisher Copyright:
© 2022 Elsevier Ltd
PY - 2022/7
Y1 - 2022/7
N2 - A 42-year-old man with a history of acute myocarditis after streptococcal pharyngitis developed recurrent fulminant myocarditis. Endomyocardial biopsy revealed myocyte degeneration, interstitial edema, and neutrophil infiltration. The patient's cardiac function deteriorated rapidly, and he died despite mechanical circulatory support. Autopsy revealed neutrophil infiltration, interstitial edema, and micro-abscesses containing masses of streptococci and neutrophilic phagocytosis within the myocardium. The patient did not meet the diagnostic criteria for acute rheumatic fever; thus, he was diagnosed with non-rheumatic streptococcal myocarditis. Non-rheumatic streptococcal myocarditis rarely recurs, but it can be fulminant upon recurrence. Learning objective: We report a rare case of recurrent fulminant non-rheumatic streptococcal myocarditis. Endomyocardial biopsy and autopsy revealed neutrophil infiltration and micro-abscesses containing bacterial masses of streptococci and neutrophilic phagocytosis in the myocardium. The patient did not meet the diagnostic criteria for acute rheumatic fever; thus, he was diagnosed with non-rheumatic streptococcal myocarditis. Non-rheumatic streptococcal myocarditis rarely recurs, but it can be fulminant upon recurrence.
AB - A 42-year-old man with a history of acute myocarditis after streptococcal pharyngitis developed recurrent fulminant myocarditis. Endomyocardial biopsy revealed myocyte degeneration, interstitial edema, and neutrophil infiltration. The patient's cardiac function deteriorated rapidly, and he died despite mechanical circulatory support. Autopsy revealed neutrophil infiltration, interstitial edema, and micro-abscesses containing masses of streptococci and neutrophilic phagocytosis within the myocardium. The patient did not meet the diagnostic criteria for acute rheumatic fever; thus, he was diagnosed with non-rheumatic streptococcal myocarditis. Non-rheumatic streptococcal myocarditis rarely recurs, but it can be fulminant upon recurrence. Learning objective: We report a rare case of recurrent fulminant non-rheumatic streptococcal myocarditis. Endomyocardial biopsy and autopsy revealed neutrophil infiltration and micro-abscesses containing bacterial masses of streptococci and neutrophilic phagocytosis in the myocardium. The patient did not meet the diagnostic criteria for acute rheumatic fever; thus, he was diagnosed with non-rheumatic streptococcal myocarditis. Non-rheumatic streptococcal myocarditis rarely recurs, but it can be fulminant upon recurrence.
KW - Autopsy
KW - Endomyocardial biopsy
KW - Fulminant
KW - Group A streptococcus
KW - Non-rheumatic streptococcal myocarditis
KW - Recurrence
UR - https://www.scopus.com/pages/publications/85127325973
UR - https://www.scopus.com/pages/publications/85127325973#tab=citedBy
U2 - 10.1016/j.jccase.2022.02.004
DO - 10.1016/j.jccase.2022.02.004
M3 - Article
AN - SCOPUS:85127325973
SN - 1878-5409
VL - 26
SP - 62
EP - 65
JO - Journal of Cardiology Cases
JF - Journal of Cardiology Cases
IS - 1
ER -