Campylobacter jejuni-Associated Perimyocarditis in 53-Year-Old Male With Chest Pain and Watery Diarrhea
Abstract
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.
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Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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