Submitted by mrhodes40 on Sun, 2007-04-08 15:55

Crit Care Med. 2007 Feb;35(2):623-6.Click here to read Links

Comment in:
Crit Care Med. 2007 Feb;35(2):670-2.

Co-infection with two Chlamydophila species in a case of fulminant myocarditis.

* Walder G,
* Gritsch W,
* Wiedermann CJ,
* Polzl G,
* Laufer G,
* Hotzel H,
* Berndt A,
* Pankuweit S,
* Theegarten D,
* Anhenn O,
* Oehme A,
* Dierich MP,
* Wurzner R.

Department of Hygiene, Microbiology and Social Medicine, Innsbruck Medical University, Innsbruck, Austria. gernot.walder@i-med.ac.at

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. DESIGN: Case report. SETTING: Intensive care unit of Innsbruck Medical University. PATIENT: A 24-yr-old patient admitted with septicemia and cardiac failure. INTERVENTIONS: Cardiopulmonary resuscitation, extracorporal membrane oxygenation, implantation of an extracorporal cardiac assist device, and antibiotic treatment with erythromycin. MEASUREMENTS AND MAIN 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.