Myocarditis related to Campylobacter jejuni infection: A case report

A 30-year-old previously healthy man presented with a history of prolonged chest pain radiating to the jaw and the left arm. Five days prior to the onset of chest pain, he developed bloody diarrhea, fever and chills. Creatine kinase (CK) and CK-MB were elevated to 289 U/L and 28.7 μg/L. Troponin I was 30.2 μg/L. The electrocardiogram (ECG) showed T wave inversion in the lateral and inferior leads. The chest pain resolved within 24 hours of admission. The patient had a completely normal ECG stress test. The patient was initiated on ciprofloxacin 500 mg po bid when Campylobacter jejuni was isolated from the stool. Diarrhea resolved within 48 hours of initiation of ciprofloxacin. The diagnosis of Campylobacter enteritis and related myocarditis was made based on the clinical and laboratory results and the patient was discharged from the hospital in stable condition.Myocarditis can be a rare but severe complication of infectious disease and should be considered as a diagnosis in patients presenting with chest pain and elevated cardiac enzymes in the absence of underlying coronary disease. It can lead to cardiomyopathy and congestive heart failure. There are only a few reported cases of myocarditis associated with Campylobacter infection.Myocarditis can result as a complication of various infectious diseases. The overall incidence of myocarditis is unknown but autopsy results have shown the frequency to be about 0.5 % to 5%.[1] Sensitive molecular techniques, such as polymerase chain reaction and in-situ hybridization, have determined infections due to enterovirus to be common causes of myocarditis in North America and Western Europe.[2,3] Myocarditis is rarely associated with bacterial infections; salmonellosis and shigellosis have been the most frequently reported cause of bacterial myocarditis.[4] There are a few case reports of myocarditis as a complication of Campylobacter jejuni infection from Europe only. [4-7]We present a case of Campylobacter jejuni-related myoca