Chlamydophila pneumoniae Myopericarditis in a Child

Abstract

An 11-year-old boy with serologically confirmed Chlamydophila pneumoniae infection presented with clinical, laboratory, and echocardiographic changes consistent with myopericarditis. No reports on C. pneumoniae myopericarditis in children are found in the medical literature. The boy, previously healthy, presented with fever, rash, constitutional symptoms, elevated acute phase reactants, elevated cardiac enzymes, and high brain natriuretic peptide levels. Hemodynamic instabilities, including hypotension and mild hypoxia, were noted. Two-dimensional echocardiographic findings showed mildly depressed left ventricular systolic function and small pericardial effusion. Requiring inotropic support, the boy was treated with azithromycin 10 mg/kg once daily for 7 days and a single dose of intravenous immunoglobulin 2 g/kg. He recovered fully with improved left ventricular systolic function before hospital discharge. An early definitive diagnosis is essential to knowing the etiology of pediatric myocarditis. Specific therapy may play role in the management and prognosis of this disorder.

Epidemiologic and clinical profiles of bacterial myocarditis. Report of two cases and data from a pooled analysis

“… 31 2005 Chlamydia pneumoniae F 24 Fever, Resp 0 5 – – VT – – 10 + + + 0 0 BVAD Definite Suesaowalak et al. 32 2008 Chlamydia pneumoniae M 11 Fever, Resp, GE, Rash + 17 32 Ripolarization abn. 0 – – 50 0 + + 0 0 – Possible Efe et al.…”

“…Patients with gastrointestinal involvement were the youngest, with an average age of 25 years 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 and always had negative blood cultures, while those with urogenital infection were the oldest, with an average age of 50 years (28.5–64.5) (p = 0.009).…”

“…The overall median LVEF at admission was 45%, 20 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 and patients with sepsis had significantly lower values (35% 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 vs 50% 39 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 ; (p < 0.001)).…”

Acute myocarditis in children

“…Reported etiologies in children include Mycoplasma pneumoniae, Chlamydophila pneumoniae, Borrelia burgdorferi, Listeria monocytogenes, Clostridium perferigens, Staphylococcus, Streptococcus, Meningococcus and Diptheria [11,[46][47][48]. In a review of children with Lyme disease, approximately 16% developed carditis with 41% of those developing advanced heart block, with an overall high rate of recovery (89%) [47].…”

Myokarditis im Kindes- und Jugendalter

“…Weitere Pathogene sind [10]: ▪ Protozoen (Toxoplasma gondii, Trypanosoma cruzi) ▪ Diphtherietoxin ▪ Pilze ▪ Hefen…”