Book contents
- Frontmatter
- Contents
- Preface
- Contributors
- Part I Clinical Syndromes – General
- Part II Clinical Syndromes – Head and Neck
- Part III Clinical Syndromes – Eye
- Part IV Clinical Syndromes – Skin and Lymph Nodes
- Part V Clinical Syndromes – Respiratory Tract
- Part VI Clinical Syndromes – Heart and Blood Vessels
- 36 Endocarditis of Natural and Prosthetic Valves: Treatment and Prophylaxis
- 37 Acute Pericarditis
- 38 Myocarditis
- 39 Mediastinitis
- 40 Vascular Infection
- 41 Pacemaker, Defibrillator, and VAD Infections
- Part VII Clinical Syndromes – Gastrointestinal Tract, Liver, and Abdomen
- Part VIII Clinical Syndromes – Genitourinary Tract
- Part IX Clinical Syndromes – Musculoskeletal System
- Part X Clinical Syndromes – Neurologic System
- Part XI The Susceptible Host
- Part XII HIV
- Part XIII Nosocomial Infection
- Part XIV Infections Related to Surgery and Trauma
- Part XV Prevention of Infection
- Part XVI Travel and Recreation
- Part XVII Bioterrorism
- Part XVIII Specific Organisms – Bacteria
- Part XIX Specific Organisms – Spirochetes
- Part XX Specific Organisms – Mycoplasma and Chlamydia
- Part XXI Specific Organisms – Rickettsia, Ehrlichia, and Anaplasma
- Part XXII Specific Organisms – Fungi
- Part XXIII Specific Organisms – Viruses
- Part XXIV Specific Organisms – Parasites
- Part XXV Antimicrobial Therapy – General Considerations
- Index
38 - Myocarditis
from Part VI - Clinical Syndromes – Heart and Blood Vessels
Published online by Cambridge University Press: 05 March 2013
- Frontmatter
- Contents
- Preface
- Contributors
- Part I Clinical Syndromes – General
- Part II Clinical Syndromes – Head and Neck
- Part III Clinical Syndromes – Eye
- Part IV Clinical Syndromes – Skin and Lymph Nodes
- Part V Clinical Syndromes – Respiratory Tract
- Part VI Clinical Syndromes – Heart and Blood Vessels
- 36 Endocarditis of Natural and Prosthetic Valves: Treatment and Prophylaxis
- 37 Acute Pericarditis
- 38 Myocarditis
- 39 Mediastinitis
- 40 Vascular Infection
- 41 Pacemaker, Defibrillator, and VAD Infections
- Part VII Clinical Syndromes – Gastrointestinal Tract, Liver, and Abdomen
- Part VIII Clinical Syndromes – Genitourinary Tract
- Part IX Clinical Syndromes – Musculoskeletal System
- Part X Clinical Syndromes – Neurologic System
- Part XI The Susceptible Host
- Part XII HIV
- Part XIII Nosocomial Infection
- Part XIV Infections Related to Surgery and Trauma
- Part XV Prevention of Infection
- Part XVI Travel and Recreation
- Part XVII Bioterrorism
- Part XVIII Specific Organisms – Bacteria
- Part XIX Specific Organisms – Spirochetes
- Part XX Specific Organisms – Mycoplasma and Chlamydia
- Part XXI Specific Organisms – Rickettsia, Ehrlichia, and Anaplasma
- Part XXII Specific Organisms – Fungi
- Part XXIII Specific Organisms – Viruses
- Part XXIV Specific Organisms – Parasites
- Part XXV Antimicrobial Therapy – General Considerations
- Index
Summary
ETIOLOGY
The majority of cases of idiopathic lymphocytic myocarditis (ILM) in the United States and Western Europe are thought to be viral in origin (Table 38.1) but there is considerable etiologic variation depending on the geographic location, season, and age of the host. The most commonly associated viruses are enteroviruses, particularly coxsackie B viruses. In research studies, enteroviral genomic sequences have been detected in approximately 25% of endomyocardial biopsies (EMB) from patients with either active myocarditis or dilated cardiomyopathy. Adenovirus and parvovirus are also common, particularly in children. Hepatitis C virus (HCV), echovirus, influenza virus, human immunodeficiency virus (HIV), and herpesviruses such as cytomegalovirus (CMV), Epstein–Barr virus (EBV), herpes simplex virus (HSV), and varicella zoster virus (VZV) also are among the more frequent viral etiologies. The myocardium sometimes demonstrates more than one virus by polymerase chain reaction (PCR) exam, but concurrent or past viral infection unrelated to the current myocarditis may be the cause of such findings. In the 2003 U.S. government program in which smallpox (vaccinia) vaccine was administered to approximately 38 000 potential first responders during a bioterrorism event, the incidence of myo/pericarditis was 5.5 per 10 000 vaccinees. Nonviral infectious causes such as Corynebacterium diphtheriae (diphtheria), Borrelia burgdorferi (Lyme disease), and American trypanosomiasis (Chagas disease) are found in the appropriate epidemiologic setting.
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- Information
- Clinical Infectious Disease , pp. 271 - 278Publisher: Cambridge University PressPrint publication year: 2008