title: Death due to eosinophilic necrotizing myocarditis despite steroid treatment.
abstract: We report a case of a 16-year-old boy who was treated for a suspected dental infection with a tooth extraction and amoxicillin therapy. The decedent developed a rash and presented to the emergency department with what was thought to be a possible allergic reaction to amoxicillin despite completion of the antibiotic course. The patient was given a course of prednisone. Several weeks later, while still completing the course of prednisone, the patient experienced shortness of breath and collapsed. Resuscitation efforts were unsuccessful. Postmortem examination revealed a necrotizing eosinophilic myocarditis. This case reveals that despite steroid therapy, a patient may still die of eosinophilic myocarditis.
authors: Ramsey County Medical Examiner's Office, St Paul, MN, USA. butch.huston@co.ramsey.mn.us
authors: Butch
authors: B
authors: Huston
authors: Victor
authors: V
authors: Froloff
authors: Kelly
authors: K
authors: Mills
authors: Michael
authors: M
authors: McGee
mesh_terms: D000293:Adolescent; D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D006332:Cardiomegaly / Q000473:pathology; D004802:Eosinophilia / Q000175:diagnosis*; D005076:Exanthema / Q000188:drug therapy; D005491:Focal Infection, Dental / Q000150:complications* / Q000628:therapy; D049429:Forensic Pathology; D005938:Glucocorticoids / Q000627:therapeutic use; D016905:Gram-Negative Bacterial Infections / Q000175:diagnosis; D006529:Hepatomegaly / Q000473:pathology; D006801:Humans; D008297:Male; D008837:Micrococcus / Q000302:isolation & purification; D009205:Myocarditis / Q000175:diagnosis*; D009206:Myocardium / Q000473:pathology*; D009336:Necrosis; D011241:Prednisone / Q000627:therapeutic use; D011654:Pulmonary Edema / Q000473:pathology; D013163:Splenomegaly / Q000473:pathology; D020615:Stenotrophomonas maltophilia / Q000302:isolation & purification; D014081:Tooth Extraction
chemical_list: D000900:Anti-Bacterial Agents; D005938:Glucocorticoids; D000658:Amoxicillin; D011241:Prednisone