MRSA-associated bacterial myocarditis causing ruptured ventricle and tamponade.
We report a case of an 81-year-old man with bacterial myocarditis presenting with elevated troponins and sepsis, who succumbed due to a ruptured ventricle. The infecting organism was found to be methicillin-resistant Staphylococcus aureus. Bacterial myocarditis is a rare occurrence when independent of infective endocarditis. Generally, this is a complication of bacteremia that is discovered post-mortem. Rarely, as in our patient, it causes significant necrosis of the myocardium leading to rupture of a ventricle. As with viral myocarditis, this disease can present with signs and symptoms of acute myocardial infarction, complicating the diagnosis. Much of the available data on bacterial myocarditis was collected before the development of many modern diagnostic tests and before antibiotics. Accordingly, the appropriate workup, diagnosis and treatment remain unclear. Our patient represents the first reported case of ventricular rupture due to methicillin-resistant S. aureus-associated bacterial myocarditis.
LeLeiko
Rebecca M
RM
Department of Medicine, Emory University School of Medicine, Atlanta, GA 30322, USA. rleleik@emory.edu
Bower
David J
DJ
Larsen
Christopher P
CP
D000369:Aged, 80 and over; D002305:Cardiac Tamponade / Q000382:microbiology*; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D006471:Gastrointestinal Hemorrhage / Q000150:complications; D006352:Heart Ventricles / Q000382:microbiology / Q000473:pathology*; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus; D009203:Myocardial Infarction / Q000150:complications; D009205:Myocarditis / Q000150:complications* / Q000382:microbiology / Q000473:pathology; D009336:Necrosis; D012422:Rupture, Spontaneous / Q000382:microbiology; D013203:Staphylococcal Infections / Q000150:complications*