Causes of Myocarditis 1. Infectious Myocarditis • Bacterial - Staphylococcus, Streptococcus, Pneumococcus, Meningococcus, Gonococcus, Salmonella, Corynebacterium diphtheriae, Haemophilus influenzae, Myobacterium (tuberculosis), Mycoplasma pneumoniae, Brucella • Spirochaetal - Borrelia (Lyme disease), Leptospira (Weil disease) • Fungal - Aspergillus, Actinomyces, Blastomyces, Candida, Coccidioides, Cryptococcus, Histoplasma, Mucormycoses, Nocardia, Sporothrix • Protozoal - Trypanosoma cruzi, Toxoplasma gondii, Entamoeba, Leishmania • Parasitic - Trichinella spiralis, Echinococcus granulosus, Taenia solium • Rickettsial - Coxiella bumetti (Q fever), R. rickettsia (Rocky Mountain Spotted fever), R. tsutsugamuschi • Viral - RNA viruses: Cox sackie viruses A and B, echo viruses, polio viruses, influenza A and B viruses, respiratory syncytial virus, mumps virus, measles virus, rubella virus, hepatitis C virus, dengue virus, yellow fever virus, Chikungunya virus, Junin virus, Lassa fever virus, rabies virus, human immunodeficiency virus-1 DNA viruses: Adenoviruses, parvovirus B 19, cytomegalovirus, human herpes virus-6, Epstein-Barr virus, varicella-zoster virus, herpes simplex virus, variola virus, vaccinia virus 2. Immune-mediated myocarditis • Allergens - Tetanus toxoid, vaccines, serum sickness. Drugs: Penicillin, cefaclor, colchicine, furosemide, isoniazid, lidocaine, tetracycline, sulfonamides, phenytoin, phenylbutazone, methyldopa, thiazide diuretics, amitriptyline • Alloantigens - Heart transplant rejection • Autoantigens - Infection-negative lymphocytic, infection-negative giant cell. Associated with autoimmune or immune-oriented disorders: Systemic lupus erythematosus, rheumatoid arthritis, Churg-Strauss syndrome, Kawasaki's disease, inflammatory bowel disease, scleroderma, polymyositis, myasthenia gravis, insulin-dependent diabetes mellitus, thyrotoxicosis, sarcoidosis, Wegener's granulomatosis, rheumatic heart disease (rheumatic fever) 3. Toxic myocarditis • Drugs - Amphetamines, anthracyclines, cocaine, cyclophosphamide, ethanol, fluorouracil, lithium, catecholamines, hemetine, interleukin-2, trastuzumab, clozapine • Heavy metals - Copper, iron, lead (rare, more commonly cause intramyocyte accumulation) • Miscellaneous - Scorpion sting, snake and spider bites, bee and wasp stings, carbon monoxide, inhalants, phosphorus, arsenic, sodium azide • Hormones - Phaeochromocytoma, vitamins: beri-beri • Physical agents - Radiation, Electric Shock #Myocarditis #Causes #differential #diagnosis #cardiology
