Near‐Fatal Myocarditis Complicating Typhoid Fever in a Traveler Returning From Nepal

Palombo, Michal; Margalit-Yehuda, Reuma; Leshem, Eyal; Sidi, Yechezkel; Schwartz, Eli

doi:10.1111/jtm.12048

Cited by 10 publications

(10 citation statements)

References 9 publications

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“… 37 2010 Salmonella enteritidis M 25 Fever, GE + – 26 ST-elevation VF 0 + 55 0 0 0 0 0 – Probable Palombo et al. 38 2013 Salmonella typhi M 27 Fever, GE + – 1.3 ST-elevation VF – + 30 0 + 0 + 0 ICD implantation Probable Williams et al. 39 2004 Salmonella typhi M 31 GE + 72 77 ST-elevation 0 + – 45 0 0 + 0 0 – Possible Uribarri et al.…”

Section: Resultsmentioning

confidence: 99%

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

Ferrero

Piazza

Lorini

et al. 2020

Indian Heart Journal

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We aimed to characterize the epidemiology, diagnostic peculiarities and outcome determinants of bacterial myocarditis. Two cases from our institution and literature reports were collected ending up with a total of 66 cases. In 37 (56%) patients, the diagnosis was confirmed by magnetic resonance and histopathological criteria. The other patients were classified as having possible myocarditis. Only occurrence of rhythm disturbances was associated with the specific diagnosis of myocarditis (p = 0.04). Thirty-two (48%) patients presented with severe sepsis that was associated with a worse prognosis. At multivariate analysis, left ventricular ejection fraction (LVEF) at admission and heart rhythm disturbances were associated with incomplete recovery (odds ratio (OR) 1.1, 95% (CI) 1.03–1.2, p = 0.004 and OR 6.6, 95% CI 1.35–32.5, p = 0.02, respectively). In summary, bacterial myocarditis is uncommon. Most commonly, it is secondary to septic dissemination of bacteria or to transient secondary myocardial toxicity.

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Section: Resultsmentioning

confidence: 99%

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

Ferrero

Piazza

Lorini

et al. 2020

Indian Heart Journal

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“…Two other cases of travelers with significant clinical myocardial involvement were published. 7 In both cases, the isolated pathogen was S. Typhi and both received medical attention after the second week of the disease. In our case series, the severe cardiac involvement was also among those infected with S. Typhi.…”

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confidence: 97%

“…Among them, four cases (a range of 6.8% from the all cases to 14.3% of patients with available ECG) had findings consistent with cardiac involvement. Two of the four in whom S. Typhi was isolated had clinical myocarditis, one of them had a life-threatening condition including ventricular fibrillation and sustained left ventricle ejection fraction reduction, 7 the other had pulmonary congestion which needed diuretics treatment. The other two who were infected with S. Paratyphi A had either ECG changes or troponin elevations, without any cardiac symptoms ( Table 2).…”

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confidence: 99%

Cardiac Involvement in Travelers with Enteric Fever

Biber

Nof

Schwartz

2019

The American Journal of Tropical Medicine and Hygiene

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Data regarding cardiac involvement in enteric fever among travelers are scarce. In this retrospective study, 59 patients were hospitalized with enteric fever during 2004-2017 and 28 had cardiac workups. Among those, four had evidence of cardiac involvement, including clinical myocarditis, electrocardiogram changes, or troponin elevation. Cardiac involvement was higher among patients infected with Salmonella Typhi than with Salmonella Paratyphi A (P = 0.08), with a significant relative risk of 6 (95% CI: 1.15-31.22, P = 0.03). Time from symptoms onset to effective treatment was longer for patients with cardiac involvement (13 versus 7.15 days, P < 0.05). It seems that cardiac involvement in enteric fever is not uncommon in travelers. Such involvement seems to be more common in patients with delay of effective treatment to the second week of illness. Although fatal or complicated cases are rare in travelers, the cardiac complication may be an important contributor to morbidity and mortality in this group. Enteric fever is a systemic disease caused by Salmonella enterica serovar Typhi or Paratyphi (Salmonella Typhi or Salmonella Paratyphi). The incidence of enteric fever in endemic regions, such as South Central Asia and southeast Asia, may rise to more than 270 per 100,000 persons/year, whereas the incidence in the industrialized world is very low, mostly acquired during travel. 1 Untreated disease can be fatal, mainly because of intestinal perforation, which can occur during the third week of the disease from necrosis of the Peyer's patches. Extraintestinal complications, including cardiovascular involvement, have also been described, mainly in endemic regions. 2-5 Data regarding myocardial involvement in returned travelers with enteric fever are scarce. We therefore conducted a retrospective analysis of all patients hospitalized in the Sheba Medical Center with culture-proven enteric fever during January 1, 2004, and October 19, 2017. Data regarding age, gender, travel history, medical history, electrocardiogram (ECG), troponin-I, and electrolytes were collected from patients' files. Every patient admitted to internal medicine ward from the emergency room undergoes an ECG as a routine. Electrocardiogram changes were defined as prolonged PR or QT intervals, abnormalities in ST intervals, any arrhythmia, or new bundle branch block. Corrected QT interval was calculated by the ECG machine and manually using Bazett and Framingham corrections. Any case with ECG changes or troponin elevation was considered having cardiac involvement. Clinical myocarditis was defined by the diagnostic criteria for clinically suspected myocarditis of the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases. 6 Only cases with ECG records were included for statistical analysis. Fisher's exact tests were used in intergroup comparisons of categorical variables, and categorical variables were expressed as numbers and percentages. Mann-Whitney U test was used for the comparison of medians, and P values lower than ...

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“…They lived in large cities abroad and their lifestyles and disease exposure profiles were rather similar to those of Western citizens. Some people who enter Western countries are not immigrants, but alien visitors, and some of them are sick [33][34][35][36] . Of note, a large proportion of those visitors originate from countries with a high incidence and prevalence of communicable diseases.…”

Section: T R O P I C a L S K I N I N F E C T I O N S O F Immigrantsmentioning

confidence: 99%

Imported Skin Infections from Tropical Regions by Travelers and Immigrants to the Belgian Mosan Region

Pi閞ard¹,

Hermanns

Pi閞ard-Franchimont

2016

Journal of Dermatological Research

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Bacterial and fungal skin infections are common in tropical medicine. They represent a spectrum of diseases somewhat different from the presentations seen in temperate and cooler climates. Some are typically exotic and confined to specific geoclimatic regions. Other more common conditions have different rates of prevalence according to regional effects. Travelers coming back from tropical regions and immigrants from these geoclimatic environments possibly transfer such dermatoses to Western residents. The global warming climate change in the world progressively alters some regional distributions of arthropod-borne-infectious diseases. The future must be framed by considering such world climatic changes responsible for progressive migration of vector-transmitted diseases inside temperate geoclimatic regions. Crowds of immigrants from warring regions eventually represent a distinct population at risk for other groups of dermatoses.

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Near‐Fatal Myocarditis Complicating Typhoid Fever in a Traveler Returning From Nepal

Abstract: We report a 27-year-old traveler who returned from Nepal suffering from typhoid fever. His disease was complicated by life-threatening myocarditis and ventricular fibrillation, a rare manifestation in travelers.

Cited by 10 publications

References 9 publications

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

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

Cardiac Involvement in Travelers with Enteric Fever

Imported Skin Infections from Tropical Regions by Travelers and Immigrants to the Belgian Mosan Region

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