Perimyocarditis Due to Yersinia enterocolitica in an Adult

We report an extremely rare case of perimyocarditis caused by Yersinia enterocolitica serotype 0:3 in a previously healthy young adult. To our knowledge, this is the first reported case of perimyocarditis in the Czech Republic and one of a limited number of reports of Y. enterocolitica carditis described globally. Upon admission to our institution, transient pericardial friction rub was audible. Electrocardiogram showed diffuse concave ST elevation, and PR segment depression was not observed. Increased cTnI (8.78 µg/L) and C-reactive protein levels (82 mg/mL) accompanied with elevated blood cell count (10.4 × 109/L) were also observed. A transthoracic echocardiography revealed a diffuse mild left ventricular hypokinesis. Anti-Y. enterocolitica serotype 0:3 antibodies were detected, and a treatment with cotrimoxazole (biseptol) was initiated. The IgM value was 112; IgG and IgE values were less than 10. The patient was discharged from the hospital in a hemodynamically stable condition after 9 days of treatment. Clinical and laboratory follow-up was performed 14 days after hospital discharge. The convalescent serology for Y. enterocolitica serotype 0:3 demonstrated conversion to positive IgG for Yersinia because the IgG value was more than 1000; IgM and IgA values were 116.8 and more than 50, respectively. Transthoracic echocardiography showed no remarkable changes compared with the previous study. C-reactive protein value decreased to 1.7 mg/L, the white blood cell count was 6.3 × 109/L, and the cTnI was less than 0.03 µg/L.