title: Acute nonrheumatic perimyocarditis complicating streptococcal tonsillitis.
abstract: Streptococcal infection is a rarely recognized cause of nonrheumatic perimyocarditis. We report a case of a young patient who developed acute perimyocarditis as manifested by diffuse electrocardiogram changes, and markedly elevated cardiac enzymes, concurrently with streptococcal tonsillitis. Despite the dramatic presentation, the patient recovered uneventfully. We conclude that streptococci can involve the heart also directly by a bacterial component or toxin, and not only through a delayed immunologic mechanism as in rheumatic fever. Further studies are necessary to accurately determine the incidence of myocardial involvement during early stages of streptococcal infection.
authors.affiliation: Department of Internal Medicine A, Hadassah University Hospital, Kiryat Hadassah, Jerusalem, Israel.
authors.forename: C
authors.initials: C
authors.lastname: Putterman
authors.forename: Y
authors.initials: Y
authors.lastname: Caraco
authors.forename: M
authors.initials: M
authors.lastname: Shalit
mesh_terms: D000328:Adult; D004562:Electrocardiography; D006801:Humans; D008297:Male; D009205:Myocarditis / Q000175:diagnosis* / Q000188:drug therapy; D010406:Penicillins / Q000627:therapeutic use; D010493:Pericarditis / Q000175:diagnosis* / Q000188:drug therapy; D013290:Streptococcal Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D013292:Streptococcus agalactiae / Q000302:isolation & purification / Q000472:pathogenicity; D014069:Tonsillitis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy
chemical_list: D010406:Penicillins