ABSTRACT
Myopericarditis is an infrequent complication of acute diarrheal illness due to Campylobacter jejuni, and it has been mainly reported in developed nations. The first case detected in Chile - an upper-middle income country -, that is coincidental with the increasing importance of acute gastroenteritis associated to this pathogen, is described. Recognition of this agent in stools requires special laboratory techniques not widely available, and it was suspected when a young patient presented with acute diarrhea, fever, and chest pain combined with electrocardiogram (EKG) abnormalities and elevated myocardial enzymes. C. jejuni myopericarditis can easily be suspected but its detection requires dedicated laboratory techniques.
Subject(s)
Adolescent , Humans , Male , Campylobacter Infections/diagnosis , Gastroenteritis/diagnosis , Myocarditis/diagnosis , Pericarditis/diagnosis , Campylobacter Infections/microbiology , Campylobacter jejuni/isolation & purification , Gastroenteritis/microbiology , Myocarditis/microbiology , Pericarditis/microbiologySubject(s)
Female , Child , Humans , Myocarditis/diagnosis , Coxsackievirus Infections , Echovirus Infections , Myocarditis/microbiologyABSTRACT
BACKGROUND & OBJECTIVES: We have earlier proposed that group A streptococcal (GAS) immunoglobulin binding surface proteins (IgGBPs) might trigger anti-IgG production and immune complex formation leading to glomerulonephritis. In the present study, cardiac tissue material from rabbits injected with heat-killed GAS was investigated. METHODS: Rabbits were injected intravenously with 10(9) colony forming units of streptococci three times weekly for 8 wk. Cardiac tissue samples were obtained at different times and deposition of IgG, C3, TNF-alpha and IL-6 was studied. RESULTS: After 8 or more weeks of intravenous (iv) injections, minimal changes were seen in animals receiving an IgG non-binding GAS strain, type T27, whereas in those animals receiving either of two IgG binding GAS strains, types M1 or M22, strong inflammatory and degenerative myocardial changes accompanied by deposition of IgG and C3 were noted. Furthermore, on injecting rabbits with defined mutants of a type M22 strain, the development of myocardial tissue damage proved to be dependent on the presence streptococcal IgGBPs. INTERPRETATION & CONCLUSION: The present data supported a role of streptococcal IgGBPs in the induction of myocardial tissue injury by GAS.
Subject(s)
Animals , Immunohistochemistry , Microscopy, Electron , Myocarditis/microbiology , Rabbits , Streptococcal Infections/microbiology , Streptococcus pyogenes/pathogenicityABSTRACT
La bronquiolitis por virus sincitial respiratorio (USR) es una enfermedad de las vías aéreas pequeñas, caracterizada por inflamación y obstrucción de los bronquiolos. El VSR fue aislado por primera vez en 1995, pertenece a la familia de los paramixovirus. Es clara la presentación epidérmica anual que compromete especialmente a lactantes pequeños. La tasa de infección por VSR durante el primer año de vida alcanza el 69 por ciento y el 83 por ciento durante el segundo. La mortalidad en niños previamente sanos es del 0.005 por ciento al 0.002 por ciento; en pacientes hospitalizados es del 1 al 3 por ciento. Aunque se ha descrito que la infección por VSR no altera la función cardíaca en pacientes con corazón sano, se encuentra en la literatura informes aislados al respecto; a continuación presentamos un caso de un paciente con bronquiolitis por VSR, en el que se documentó miocarditis por este mismo germen.
Subject(s)
Humans , Infant , Male , Bronchiolitis, Viral/diagnosis , Bronchiolitis, Viral/drug therapy , Bronchiolitis, Viral/etiology , Bronchiolitis, Viral/history , Bronchiolitis, Viral/microbiology , Bronchiolitis, Viral/nursing , Myocarditis/classification , Myocarditis/drug therapy , Myocarditis/epidemiology , Myocarditis/history , Myocarditis/microbiology , Myocarditis/nursing , Myocarditis/physiopathology , Respiratory Syncytial Viruses/chemistry , Respiratory Syncytial Viruses/isolation & purification , Respiratory Syncytial Viruses/pathogenicity , Respiratory Syncytial Viruses/physiologyABSTRACT
PURPOSE--To analyze myocardial abnormalities in patients of acquired immunodeficiency syndrome with clinical and pathological correlation. METHODS--We selected 50 cases, retrospectively, age ranged from 3 months to 40 years, all of them had myocardial changes and the data of clinical records fulfilled our protocol. Cases of others cardiac diseases were not included. RESULTS--The pathological findings were: myocarditis in 33 (11 had severe myocarditis) and degenerative hystological lesions in 17. The etiologic agents detected were: Toxoplasma in 11, Cryptococcus in 7 and Cytomegalovirus in 3. In 12 cases we could not find any agent. In 15 cases occurred others lesions: endocarditis, pericarditis and sarcoma of Kaposi. It was noted tachycardia in 15 cases, decrease of heart sounds in 12, arterial hypotension in seven, systolic murmur in 8, galop rhythm in 7, pericardial friction rub in 3, arrhythmia in 2. Four patients had congestive heart failure. The EKG showed sinus tachycardia in 18, ST and T changes in 10, low voltage in 5, ST segment elevation in 5 and extrasystoles in 3 cases. The echocardiogram findings were: pericardial effusion in 9 cases and 9 had ventricular dysfunction. CONCLUSION--The cardiac lesions were very important even in patients without clinical signals. We need others prospective studies with viral identification trying to detect specific lesions of HIV
Objetivo - Analisar as alterações miocárdicas na síndrome da imunodeficiência adquirida e correlacionar os achados clínicopatológicos. Métodos - Foram selecionados, retrospectivamente, 50 pacientes entre 4 meses e 40 anos de idade, que apresentavam lesões miocárdicas à histologia e cujos prontuários continham os dados do protocolo. Foram in cluídos aqueles com lesões cardíacas de outra etiologia. Resultados - Os achados anatomopatológicos foram miocardite em 33 (66%) casos, sendo grave em 11 e lesões degenerativas em 17. Os agentes etiológicos foram Toxoplasma em 11, Criptococcus em 7, Citomegalovírus em 3 e inespecífica em 12. Em 15 casos havia também outras lesões como endocardite, pericardite e sarcoma de Kaposi. Quanto aos achados clínicos observamos taquicardia em 15 casos, hipofonese de bulhas em 12, hipotensão arterial em 7, sopro sistólico em 8, ritmo de galope em 7, atrito pericárdico em 3 e arritmia cardíaca em 2. Quatro pacientes tiveram sinais de insuficiência cardíaca congestiva. O ECG mostrou taquicardia sinusal em 18, distúrbio de repolarização em 10, baixa voltagem em 5, supradesnivelamento de ST em 5 e extra-sistolia em 3. Ao ecocardiograma 9 apresentaram derrame pericárdico e 9 diminuição de contratilidade ou da função ventricular. Conclusão - As lesões cardíacas foram expressivas mesmo em pacientes sem sinais clínicos para tal. São necessários mais estudos com métodos de identificação viral para tentar detectar as lesões miocárdicas pelo HIV.
Subject(s)
Humans , Animals , Male , Female , Infant , Child, Preschool , Child , Adult , Myocarditis/pathology , Acquired Immunodeficiency Syndrome/pathology , Cryptococcus/isolation & purification , Cytomegalovirus/isolation & purification , Electrocardiography , Myocarditis/microbiology , Myocarditis/parasitology , Myocarditis/virology , Acquired Immunodeficiency Syndrome/complications , Acquired Immunodeficiency Syndrome/microbiology , Acquired Immunodeficiency Syndrome/parasitology , Acquired Immunodeficiency Syndrome/virologyABSTRACT
A fatal case of chickenpox in a healthy 6-year-old girl is reported. She presented with hemorrhagic bullae from thrombocytopenia and then progressed rapidly to disseminated infection involving many systems causing myocarditis, pneumonitis and hepatitis. A peculiar blood picture with marked leukocytosis (leukemoid reaction) is revised and discussed.
Subject(s)
Chickenpox/complications , Child , Female , Hepatitis, Viral, Human/microbiology , Humans , Leukocytosis/etiology , Myocarditis/microbiology , Pneumonia, Viral/microbiology , Purpura, Thrombocytopenic/etiologyABSTRACT
Twenty-one patients of whom 13 had acute rheumatic fever and 8 had recurrence of rheumatic fever were studied for the evidence of coxsackie B viral infection using neutralisation test. A significant rise was noted in 17 cases (81%) and two cases had very high initial titre of neutralising antibodies to coxsackie B viruses type 1 to 6. Mixed infection with more than one serotype was seen in 11 cases. Coxsackie B2 was the commonest type and 14 patients had antistreptolysin 'O' anti-bodies. The high incidence of coxsackie B viral infection in rheumatic fever and the coexistent streptococcal infection and their relationship are discussed.
Subject(s)
Adolescent , Adult , Coxsackievirus Infections/microbiology , Diagnosis, Differential , Enterovirus B, Human/isolation & purification , Female , Humans , Male , Myocarditis/microbiology , Rheumatic Heart Disease/microbiology , Streptococcal Infections/microbiology , Streptococcus/isolation & purificationABSTRACT
La miocarditis aguda viral es una entidad especialmente de jóvenes caracterizada por fiebre, precordialgia, disnea y palpitaciones, puede evolucionar hacia una cardiomiopatía dilatada y ocasionalmente a la muerte. Se presenta el caso de un paciente de 19 años, que ingresó por fiebre, disnea, tos, expectación hemoptoica, precordialgia, edema miembros inferiores y diarrea, precedidas de proceso gripal. Se realiza EGC, Rx. toráx, ecocardiograma, estudio virológico e inmunológico, cateterismo cardíaco, biopsia endomiocárdica. Se destaca la importancia de ésta para el seguimiento y pronóstico en estos pacientes
Subject(s)
Adult , Humans , Male , Enterovirus B, Human/pathogenicity , Myocarditis/microbiologyABSTRACT
A female nurse with bacteriological and serological proven typhoid fever developed jaundice and laboratory evidence of hepatitis with electrocardiographic finding of myocarditis. Liver function tests and ECG changes returned to normal after treatment with chlormphenicol. Clinical aspects are discussed with review of literatures
Subject(s)
Myocarditis/microbiologyABSTRACT
A preliminary report on an unidentified virus from two cases of infantile myocarditis is presented. The virus isolated from two separate occasions showed characteristics of an enterovirus. The significance of this virus in its association with infantile myocarditis requires further investigation.