Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Jan 26, 2020; 12(1): 67-75
Published online Jan 26, 2020. doi: 10.4330/wjc.v12.i1.67
Salmonella typhimurium myopericarditis: A case report and review of literature
David Jin, Chien-Ying Kao, Jonathon Darby, Sonny Palmer
David Jin, Sonny Palmer, Department of Medicine at St Vincent’s Hospital, The University of Melbourne, Parkville 3052, Australia
David Jin, Chien-Ying Kao, Sonny Palmer, Department of Cardiology, St Vincent’s Hospital Melbourne, Fitzroy 3065, Australia
Jonathon Darby, Department of Infectious Diseases, St Vincent’s Hospital Melbourne, Fitzroy 3065, Australia
Author contributions: Jin D, Darby J, and Palmer S designed the research; Jin D and Kao CY preformed the literature review; Darby J and Palmer S contributed to the writing of the discussion; Jin D and Kao CY wrote the paper.
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment. Copy of this statement is available upon request.
Conflict-of-interest statement: David Jin is funded by a government commonwealth research scholarship. There are no declared conflicts of interest for any of the authors.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: David Jin, MD, Doctor, Department of Medicine at St Vincent’s Hospital, The University of Melbourne, Parkville 3052, Australia. d.jin2@unimelb.edu.au
Received: June 21, 2019
Peer-review started: June 23, 2019
First decision: September 21, 2019
Revised: November 4, 2019
Accepted: November 20, 2019
Article in press: November 21, 2019
Published online: January 26, 2020
Processing time: 188 Days and 3.4 Hours
Abstract
BACKGROUND

Non-typhoidal salmonella (NTS) is a rare, but well-established cause of myopericarditis. Presenting symptoms may be varied, however often revolve around the dual presentation of both myopericarditis and infectious diarrhoea. Given the rarity of NTS related myopericarditis, we conducted a systematic review of the literature, identifying 41 previously reported cases.

CASE SUMMARY

We present the case of an otherwise healthy 39-year old male, presenting with chest pain in the setting of documented Salmonella typhimurium infection. After further investigation with echocardiogram and laboratory blood tests, a diagnosis of NTS associated myopericarditis was made, and the patient received antibiotic treatment with an excellent clinical outcome. Overall, myopericarditis is rare in NTS. Although treatment for myopericarditis has not been well established, there are guidelines for the treatment of NTS infection. In our review, we found that the majority of NTS cases has been pericarditis (27/42, 64.3%), with an average age of 48.3 years, and 71.4% being male. The average mortality across all cases was 31%.

CONCLUSION

Myopericarditis is a rare, but potentially serious complication of NTS infection, associated with an increased morbidity and mortality.

Keywords: Salmonella typhimurium; Pericarditis; Myocarditis; Myopericarditis; Non-typhoidal salmonella; Case report

Core tip: Myopericarditis symptoms can be variable but generally presents with ischaemic sounding chest pain or pleuritic chest pain and cardiac biomarker elevation (troponin I and T). Non-typhoidal salmonella (NTS) generally presents as a non-bloody infectious diarrhoea. Salmonella enterica has multiple subtypes, with Salmonella typhi and paratyphi causing typhoid fever. However, there are a large number of NTS, which may include Salmonella choleraesuis, enteritidis, and typhimurium. Relevant investigations may consist of laboratory blood tests, electrocardiogram, echocardiography, coronary angiography, cardiac magnetic resonance imaging, cardiac biopsy, and faecal culture for Salmonella. Salmonella is a rare cause of myopericarditis; however, it should be considered when patients with symptoms of myocarditis or pericarditis present with a history of diarrhoea, abdominal pain and fever.