title: Chest pain and diarrhea: a case of Campylobacter jejuni-associated myocarditis.
abstract: BACKGROUND
  Diarrhea and chest pain are common symptoms in patients presenting to the emergency department (ED). However, rarely is a relationship between these two symptoms established in a single patient.
  
  
  OBJECTIVE
  Describe a case of Campylobacter-associated myocarditis.
  
  
  METHODS
  A 43-year-old man with a history of hypertension presented to the ED with angina-like chest pain and a 3-day history of diarrhea. Electrocardiogram revealed ST-segment elevation in the lateral leads. Coronary angiogram revealed no obstructive coronary artery disease. Troponin T rose to 1.75 ng/mL. Cardiac magnetic resonance imaging showed subepicardial and mid-myocardial enhancement, particularly in the anterolateral wall and interventricular septum, consistent with a diagnosis of myocarditis. Stool studies were positive for Campylobacter jejuni.
  
  
  CONCLUSIONS
  Campylobacter-associated myocarditis is rare, but performing the appropriate initial diagnostic testing, including stool cultures, is critical to making the diagnosis. Identifying the etiology of myocarditis as bacterial will ensure that appropriate treatment with antibiotics occurs in addition to any cardiology medications needed for supportive care.
authors.affiliation: Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas.
authors.forename: Ragesh
authors.initials: R
authors.lastname: Panikkath
authors.affiliation: Department of Internal Medicine, Mayo Clinic, Scottsdale, Arizona.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Costilla
authors.affiliation: Division of Cardiology, Mayo Clinic, Scottsdale, Arizona.
authors.forename: Priscilla
authors.initials: P
authors.lastname: Hoang
authors.affiliation: Department of Emergency Medicine, Mayo Clinic, Scottsdale, Arizona.
authors.forename: Joseph
authors.initials: J
authors.lastname: Wood
authors.affiliation: Department of Radiology, Mayo Clinic, Scottsdale, Arizona.
authors.forename: James F
authors.initials: JF
authors.lastname: Gruden
authors.affiliation: Department of Emergency Medicine, Mayo Clinic, Scottsdale, Arizona.
authors.forename: Bob
authors.initials: B
authors.lastname: Dietrich
authors.affiliation: Department of Radiology, Mayo Clinic, Scottsdale, Arizona.
authors.forename: Michael B
authors.initials: MB
authors.lastname: Gotway
authors.affiliation: Division of Cardiology, Mayo Clinic, Scottsdale, Arizona.
authors.forename: Christopher
authors.initials: C
authors.lastname: Appleton
mesh_terms: D000328:Adult; D002169:Campylobacter Infections / Q000175:diagnosis*; D016123:Campylobacter jejuni; D002637:Chest Pain / Q000175:diagnosis*; D003967:Diarrhea / Q000175:diagnosis*; D006801:Humans; D008297:Male; D009205:Myocarditis / Q000382:microbiology*
keywords: Campylobacter jejuni; diarrhea; myocarditis; myopericarditis