Laboratory diagnosis of myocarditis and pericarditis. Part I: Microbiologic investigations 1

Inflammatory disorders of the heart can be classified as myocarditis, pericarditis or endocarditis. Myocarditis is an acute or chronic inflammation affecting the myocardium. Next to viral infections bacterial pathogens represent the most important cause of myocarditis in Europe and North America. Different bacterial, fungal and parasite agents also play an important role in the pathophysiology of inflammatory heart disorders. In addition to infectious agents, a wide variety of toxins and drugs (e.g., cocaine«) and some chronic autoimmune diseases (lupus) also have the ability to cause myocarditis. Clinical features of acute or chronic myocarditis are often non-specific, ranging from mild to life-threatening symptoms (sudden cardiac death, chronic heart failure«). In 25% of cases, myocarditis is associated with a pericardial infection. Many isolated pericarditis cases are seen during disseminated purulent bacterial infections and tuberculosis.