Chest pain is a common presenting complaint in adolescent patients. Myocarditis is an important and potentially serious etiology of chest pain for clinicians who care for these patients to recognize. Myocarditis is commonly virally mediated, while extra-intestinal cardiac manifestations of bacterial enteritis, such as infections,are rare. Awareness of this uncommon, but potentially life-threatening pathophysiology is important for clinicians to understand. In our case, a 17-year-old male presented with chest discomfort, chest pain on inspiration, headache, myalgias, vomiting, and diarrhea. He denied recent viral illnesses or immunizations. He lived in rural Ohio, swam recently in a freshwater lake, and had eaten home-prepared deer meat. His father had diarrhea as well. Presenting vital signs were within normal limits for age. The patient was obese (BMI 48.5), with an otherwise normal physical exam, including a thorough cardiopulmonary assessment. Laboratory workup revealed leukocytosis (16.1 x 10/L) and elevated high-sensitivity troponin (15,857 ng/L, >22,000 ng/L three hours later, ref range <20). Gastrointestinal polymerase chain reaction (PCR) panel detected spp., and stool culture was positive for . ECG, echocardiography, chest X-ray, and CT angiography were normal. Cardiac MRI revealed an increased T2 signal consistent with myocarditis. The patient was treated with non-steroidal anti-inflammatory drugs (NSAIDs) and azithromycin and had complete resolution in symptoms. He was exercise-restricted for six months. Myocarditis is a potentially fatal pathology, representing a significant cause of sudden death in young adults. Myocarditis can present with a broad spectrum of signs and symptoms as well as variable clinical severity. Bacterial causes of myocarditis are uncommon, with among the least common. gastroenteritis, however, is quite common worldwide. Extra-intestinal and cardiac manifestations are rare; thus, it is important to maintain a high index of suspicion. Due in part to its rarity, treatment for associated myocarditis is not well established. Treatment for myocarditis, regardless of etiology, is largely supportive in nature. -directed antibiotics, such as azithromycin, have been used successfully in adolescents with -associated myocarditis. Non-steroidal anti-inflammatory drugs (NSAIDs) are frequently used for symptom control, though their use remains controversial. Activity restriction is recommended for six months to reduce the risk of sudden cardiac death. Myocarditis is an important cause of sudden death in young adults and is a rare extra-intestinal manifestation of bacterial gastroenteritis. Pediatric and adult providers should be aware of this presentation and its pathophysiology. They should also utilize a multi-modal workup, aggressive supportive care, appropriate subspecialty consultation, and appropriate antibiotics for patients with diarrheal illness and a high clinical suspicion for extra-intestinal involvement, such as myocarditis.
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http://dx.doi.org/10.7759/cureus.68326 | DOI Listing |
Cureus
December 2024
Baltimore Neurosurgery and Spine Center, Sinai Hospital of Baltimore, Baltimore, USA.
Cervical synovial cysts are rare, especially hemorrhagic cervical synovial cysts. The patient was a 58-year-old male with a five-month history of tingling in his right shoulder region, radicular pain in his right arm, and increased pain on the right chest wall that worsened with lying supine down. The patient was diagnosed with a right-sided hemorrhagic synovial cyst at the C7-T1 level.
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December 2024
Internal Medicine, Weiss Memorial Hospital, Chicago, USA.
A previously healthy, 28-year-old man presented with a two-day history of diarrhea and chest pain, suggestive of infectious myocarditis. Initial workup revealed elevated troponin-I levels and diffuse ST-segment elevations on electrocardiogram (ECG). Transthoracic echocardiography showed a reduced left ventricular ejection fraction (40-45%), posteroinferior wall akinesis, and a small pericardial effusion.
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December 2024
Department of Critical Care Medicine, Cheeloo College of Medicine, Qilu Hospital (Qingdao), Shandong University, Qingdao, Shandong, China.
Introduction: Cardiac arrest during pregnancy is receiving increasing attention. However, there are few reports on cardiac arrest in nonpregnant women caused by abnormal uterine bleeding (AUB). We report a case in which extracorporeal cardiopulmonary resuscitation (ECPR) was used in a patient with cardiac arrest caused by AUB and coronary vasospasm.
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January 2025
Department of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences Okayama University Okayama Japan.
Blunt abdominal trauma causing intraperitoneal injury and/or bleeding can be life-threatening, requiring immediate intervention. Diagnosing these cases can be challenging, especially when pre-existing conditions are involved. Low-grade appendiceal mucinous neoplasm (LAMN) is a rare tumor of the appendix that can lead to pseudomyxoma peritonei.
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February 2025
MARS Lab, Department of Computer Science and Engineering, Daffodil International University, Daffodil Smart City, Birulia, Dhaka 1216, Bangladesh.
Anemia is a critical medical condition in public health concern in tropical and subtropical areas, and understanding its hematological changes is crucial for improving diagnosis, treatment, and prognosis.It manifests through symptoms like weakness, fatigue, pale skin, and shortness of breath due to insufficient hemoglobin or red blood cells to carry adequate oxygen, with severe cases leading to complications such as chest pain. Common causes include blood loss, chronic diseases, and iron and vitamin deficiencies.
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