Fast Five Quiz: Myocarditis

Yasmine S. Ali, MD

Disclosures

December 13, 2021

Viral infections are the most common cause of myocarditis in the United States and other developed countries. Viruses responsible include:

  • SARS-CoV-2

  • Enterovirus

  • Coxsackie B

  • Adenovirus

  • Influenza

  • Cytomegalovirus

  • Poliomyelitis

  • Epstein-Barr virus

  • HIV-1

  • Viral hepatitis

  • Mumps

  • Rubeola

  • Varicella

  • Variola/vaccinia

  • Arbovirus

  • Respiratory syncytial virus

  • Herpes simplex virus

  • Yellow fever virus

  • Rabies

  • Parvovirus

Other causes of myocarditis include:

  • Chemotherapeutic drugs: doxorubicin and anthracyclines, streptomycin, cyclophosphamide, interleukin-2, anti-HER-2 receptor antibody/Herceptin

  • Antibiotics: penicillin, chloramphenicol, sulfonamides

  • Antihypertensive drugs: methyldopa, spironolactone

  • Antiseizure drugs: phenytoin, carbamazepine

  • Amphetamines, cocaine, catecholamines

  • Chemicals: hydrocarbons, carbon monoxide, arsenic, lead, phosphorus, mercury, cobalt

  • Rickettsial causes: scrub typhus, Rocky Mountain spotted fever, Q fever

  • Bacterial causes: diphtheria, tuberculosis, streptococci, meningococci, brucellosis, clostridia, staphylococci, melioidosis, Mycoplasma pneumoniae, psittacosis

  • Spirochetal causes: syphilis, leptospirosis/Weil disease, relapsing fever/Borrelia, Lyme disease

  • Fungal causes: candidiasis, aspergillosis, cryptococcosis, histoplasmosis, actinomycosis, blastomycosis, coccidioidomycosis, mucormycosis

  • Protozoal causes: Chagas disease, toxoplasmosis, trypanosomiasis, malaria, leishmaniasis, balantidiasis, sarcosporidiosis

  • Helminthic causes: trichinosis, echinococcosis, schistosomiasis, heterophyiasis, cysticercosis, visceral larva migrans, filariasis

  • Bites/stings: scorpion venom, snake venom, black widow spider venom, wasp venom, tick paralysis

  • Physical agents (radiation, heatstroke, hypothermia)

  • Acute rheumatic fever

  • Systemic inflammatory disease: giant cell myocarditis, sarcoidosis, Kawasaki disease, Crohn's disease, systemic lupus erythematosus, ulcerative colitis, Wegener granulomatosis, thyrotoxicosis, scleroderma, rheumatoid arthritis

  • Peripartum cardiomyopathy

  • Posttransplant cellular rejection

Read more on the etiology of myocarditis.

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