Co-infection with two Chlamydophila species in a case of fulminant myocarditis.
OBJECTIVE
The aim of this study is to describe a case of fulminant myocarditis caused by co-infection with Chlamydophila pneumoniae and Chlamydophila psittaci in order to facilitate diagnosis and clinical management of patients suffering from this rare but life-threatening condition.


METHODS
Case report.


METHODS
Intensive care unit of Innsbruck Medical University.


METHODS
A 24-yr-old patient admitted with septicemia and cardiac failure.


METHODS
Cardiopulmonary resuscitation, extracorporal membrane oxygenation, implantation of an extracorporal cardiac assist device, and antibiotic treatment with erythromycin.


RESULTS
Cp. pneumoniae and Cp. psittaci were identified by means of polymerase chain reaction and electron microscopy in the patient's myocytes. Successful weaning off the ventricular assist device was performed within 2 wks after commencement of antibiotic therapy.


CONCLUSIONS
This case report demonstrates co-infection with Cp. pneumoniae and Cp. psittaci to be a hitherto unknown cause of fulminant myocarditis. There is a particular risk of misdiagnosis of viral myocarditis, which must be avoided. Patients should be transferred to a center where extracorporal membrane oxygenation therapy and molecular diagnosis of all members of the family Chlamydiaceae are available.
Walder
Gernot
G
Department of Hygiene, Microbiology and Social Medicine, Innsbruck Medical University, Innsbruck, Austria. gernot.walder@i-med.ac.at
Gritsch
Walter
W
Wiedermann
Christian J
CJ
Pölzl
Gerhard
G
Laufer
Günther
G
Hotzel
Helmut
H
Berndt
Angela
A
Pankuweit
Sabine
S
Theegarten
Dirk
D
Anhenn
Olaf
O
Oehme
Albrecht
A
Dierich
Manfred P
MP
Würzner
Reinhard
R
D000328:Adult; D023521:Chlamydophila Infections; D016993:Chlamydophila pneumoniae; D002691:Chlamydophila psittaci; D005260:Female; D006801:Humans; D009205:Myocarditis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*