title: Co-infection with two Chlamydophila species in a case of fulminant myocarditis.
abstract: 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.
authors.affiliation: Department of Hygiene, Microbiology and Social Medicine, Innsbruck Medical University, Innsbruck, Austria. gernot.walder@i-med.ac.at
authors.forename: Gernot
authors.initials: G
authors.lastname: Walder
authors.forename: Walter
authors.initials: W
authors.lastname: Gritsch
authors.forename: Christian J
authors.initials: CJ
authors.lastname: Wiedermann
authors.forename: Gerhard
authors.initials: G
authors.lastname: Pölzl
authors.forename: Günther
authors.initials: G
authors.lastname: Laufer
authors.forename: Helmut
authors.initials: H
authors.lastname: Hotzel
authors.forename: Angela
authors.initials: A
authors.lastname: Berndt
authors.forename: Sabine
authors.initials: S
authors.lastname: Pankuweit
authors.forename: Dirk
authors.initials: D
authors.lastname: Theegarten
authors.forename: Olaf
authors.initials: O
authors.lastname: Anhenn
authors.forename: Albrecht
authors.initials: A
authors.lastname: Oehme
authors.forename: Manfred P
authors.initials: MP
authors.lastname: Dierich
authors.forename: Reinhard
authors.initials: R
authors.lastname: Würzner
mesh_terms: D000328:Adult; D023521:Chlamydophila Infections; D016993:Chlamydophila pneumoniae; D002691:Chlamydophila psittaci; D005260:Female; D006801:Humans; D009205:Myocarditis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*