Key result
Speckle-tracking echo detects MRI-matched subepicardial impairment in Legionella myocarditis that improves with levofloxacin.
Why the study?
Extrapulmonary manifestations of legionellosis are uncommon and the basic mechanisms of myocardial involvement remain unclear, with few descriptions of associated acute myocarditis.
Does levofloxacin improve left ventricular systolic function in a patient with acute myocarditis associated with Legionella infection?
Case Report (n=1)
No
Does levofloxacin improve left ventricular systolic function in a patient with acute myocarditis associated with Legionella infection?
This case report highlights that acute myocarditis can be a rare extrapulmonary manifestation of Legionella infection, which may resolve rapidly with appropriate antibiotic therapy.
Answers are grounded in this paper and cite their sources.
May support targeted antibiotics in rare Legionella myocarditis; leaves open layer-specific strain utility pending prospective data.
infection (legionellosis), and extrapulmonary manifestations are uncommon. There are a few descriptions of acute myocarditis associated with legionellosis. We present a case of acute myocarditis in a patient admitted for legionellosis with multisystemic involvement (lung, heart, and kidney). Left ventricular (LV) dysfunction was documented by cardiac magnetic resonance (CMR) and two-dimensional speckle-tracking echocardiography; layer-specific strain analyses were performed, which allowed to differentiate subendocardial or subepicardial contractile impairment. Layer-specific strain analyses by echocardiography demonstrated impairment of subepicardial deformation in the inferolateral wall, which mirrored CMR findings, showing late gadolinium enhancement in the subepicardium of the same LV segments. After initiation of appropriate antibiotic therapy with levofloxacin, LV systolic function rapidly improved as assessed by both CMR and strain analyses, with concomitant normalization of both clinical and biochemical abnormalities. The basic mechanisms of myocardial involvement during legionellosis are unclear; we discussed our findings according to the limited available evidence.
No takes yet. Share an insight, caveat, or question.
Spighi et al. (2021) conducted a case report in Acute myocarditis associated with Legionella infection (n=1). Levofloxacin and layer-specific two-dimensional longitudinal speckle-tracking echocardiography was evaluated on Left ventricular ejection fraction and global longitudinal strain. Layer-specific speckle-tracking echocardiography identified subepicardial impairment mirroring MRI findings in Legionella-associated myocarditis, which improved after levofloxacin therapy.
Synapse has enriched 10 related papers. Consider them for comparative context: