Pericardial and myocardial disease associated with serological evidence of infection by agents of the psittacosis-lymphogranuloma venereum group (Chamydiaceae)

Chlamydia psittaci-related pleuro-myocarditis

Chlamydia psittaci ‒ related community-acquired pneumonia associated to acute myocarditis was diagnosed in a young man with no medical history, and a professional exposition to birds. The diagnosis was confirmed with positive specific polymerase chain reaction in bronchoalveolar lavage. The patient was treated with spiramycin for two weeks with anti-inflammatory treatment for myocarditis for three months. Clinical and biological improvement was rapidly observed followed by normalization of electrocardiogram and chest CT scan. No relapse was reported for over a two-year follow-up.

Background and current knowledge of Chlamydia pneumoniae and atherosclerosis

Attributes of Chlamydia pneumoniae of potential importance to a relationship with atherosclerosis are described. Among these are that C. pneumoniae is not new. It is unique. It is a pathogen with which everyone is infected, and it is difficult to treat. It causes immunopathology, myocarditis, and endocarditis and chronicity is a hallmark of Chlamydia infection. Current knowledge of the relation of C. pneumoniae and atherosclerosis comes from observational (e.g., seroepidemiology and tissue studies) and experimental studies. The limitations of the serologic studies of chronic infection are noted as is the conclusive demonstration of an association of C. pneumoniae and atherosclerosis by the repeated and frequent finding of the organism in atherosclerotic tissue. Experimental studies are needed to determine if the association is causal. Such studies should include animal models, basic mechanisms, and secondary prevention antibiotic treatment trials.

Echocardiographic follow-up of Chlamydia psittaci myocarditis

Chlamydia psittaci myocarditis has been infrequently reported. A case of serologically confirmed C psittaci myocarditis with dilated left ventricle and severely impaired left ventricular function is described. Serial echocardiograms demonstrated complete recovery after therapy. An early diagnosis has important prognostic implications.

Myopericarditis due to Chlamydia psittaci. The role of autoimmunity

Chlamydia psittaci may rarely involve the heart as the only manifestation of the infection. We report a case of myopericarditis caused by this agent, whose pathogenesis seemed to be autoimmune damage triggered by the infection.

Chlamydial infections of the heart

Chlamydiae are common human pathogens, causing a broad spectrum of infectious diseases. Chlamydial infections involving the heart have been described in numerous previous reports. These organisms are documented to cause endocarditis, myocarditis and pericarditis. Furthermore, Chlamydia pneumoniae, the recently discovered respiratory pathogen, has also been implicated in coronary artery disease. For the first time the literature on involvement of the heart in chlamydial infections is reviewed. Information on the discovery of Chlamydia species is also included and the problem of the species determination of Chlamydia in interpretation of the older literature is mentioned.

Dilated cardiomyopathy associated with Chlamydia trachomatis infection

A 26-year-old man was admitted to hospital with acute myocarditis complicated by congestive heart failure, and atrial and ventricular arrhythmias. Detailed investigations to determine the aetiological factors involved yielded negative results, except for serological evidence of infection with Chlamydia trachomatis. During the follow-up period, dilated cardiomyopathy developed. To the best of our knowledge a similar case has not been reported previously.

Serological evidence of an association of a novel Chlamydia, TWAR, with chronic coronary heart disease and acute myocardial infarction

Paired sera from 40 male patients with acute myocardial infarction (AMI), 30 male patients with chronic coronary heart disease (CCHD), and 41 controls, matched for sex, age, time, and locality were investigated for antibodies to a novel type of Chlamydia sp, TWAR, and to chlamydial lipopolysaccharide (LPS) group antigen. 27 patients with AMI (68%), and 15 (50%) patients with CCHD had raised IgG (greater than or equal to 128) and/or IgA (greater than or equal to 32) titres in the microimmunofluorescence test with chlamydia TWAR. Both frequencies were significantly higher than in the controls (7, 17%). 26 (68%) of 38 patients with AMI also showed a significant seroconversion in enzyme immunoassay with LPS antigen; this response was absent in all patients with CCHD and all but 1 of the controls. Chronic chlamydial infection could be a factor in the pathogenesis of cardiovascular diseases.

A progressive pericardial effusion caused by psittacosis

A patient developed signs of a progressive pericardial effusion over a period of eight days. Diagnostic and therapeutic pericardiocentesis was performed. Viral titres to psittacosis rose from less than 1:8 to greater than 1:256 indicating recent infection.

Pericardial effusion complicating psittacosis infection

A 13-year-old schoolboy developed a moderately large pericardial effusion during the course of infection with psittacosis. The value of echocardiography in differentiating between pericardial effusion and myocarditis is shown.

Endocarditis caused by a psittacosis agent

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