Myocarditis in a young male affected with monkeypox infection: a case report

Abstract Background Concerns on monkeypox as a disease impacting global public health first emerged in May, 2022, and, since that time, has been identified in more than 50 countries. The condition mainly affects men who have sex with other men. Cardiac disease is a rare complication of monkeypox inf...

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Bibliographic Details
Published in:European heart journal : case reports 2023-05, Vol.7 (5), p.ytad211
Main Authors: Luengo Pérez, Sergio, Abdala Lizarraga, Julián, Jaén Ferrer, Esther, Ridocci Soriano, Francisco
Format: Article
Language:English
Subjects:
Case Report
Colchicine
Diseases
Electrocardiogram
Electrocardiography
Health aspects
Human monkeypox
Myocarditis
Sexually transmitted diseases
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Summary:Abstract Background Concerns on monkeypox as a disease impacting global public health first emerged in May, 2022, and, since that time, has been identified in more than 50 countries. The condition mainly affects men who have sex with other men. Cardiac disease is a rare complication of monkeypox infection. Here, we describe a case of myocarditis in a young male subsequently diagnosed with monkeypox infection. Case summary A 42-year-old male reported engaging in high-risk sexual behaviours with another male 10 days before presenting to the emergency department with chest pain, fever, maculopapular rash, and a necrotic chin lesion. Electrocardiography revealed diffuse concave ST-segment elevation associated with elevated cardiac biomarkers. Transthoracic echocardiography revealed normal biventricular systolic function without wall motion abnormalities. We excluded other sexually transmitted diseases or viral infections. Cardiac magnetic resonance imaging (MRI) findings suggested myopericarditis involving the lateral wall and adjacent pericardium. The results of polymerase chain reaction (PCR) tests of pharyngeal, urethral, and blood samples were positive for monkeypox. The patient was treated with high-dose non-steroidal anti-inflammatory drugs (NSAIDs) and colchicine and he recovered soon. Discussion Monkeypox infections are generally self-limited, with most patients experiencing benign clinical outcomes, no hospitalizations, and few complications. This is a rare report of monkeypox complicated with myopericarditis. Management with high-dose NSAIDs and colchicine relieved our patient's symptoms, suggesting a similar clinical outcome as other idiopathic or virus-related myopericarditis.
ISSN:2514-2119
2514-2119
DOI:10.1093/ehjcr/ytad211