This case highlights the rare occurrence of giant cell myocarditis secondary to myocardial tuberculosis, which resolved with antituberculous therapy rather than long-term immunosuppression.
May spare long-term immunosuppression in TB-associated giant cell myocarditis; leaves open confirmation beyond this case.
This case highlights the importance of considering a wide differential diagnosis in a young patient with chest pain and an abnormal ECG. Rarer causes of myocarditis such as GCM should be sought in patients who develop ventricular arrhythmias or high-grade heart block because the treatment is different and dramatically influences outcome. Our patient is the first reported case of GCM and a concurrent diagnosis of tuberculosis. It is most likely that the histological appearance of GCM was due to the presence of mycobacterial infection within the myocardium, and we believe that effective antituberculous therapy has led to resolution of the GCM without the need for continued long-term immunosuppression.
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Everett et al. (2013) studied this question.
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