Causes (Etiology)

Jan Habásko — Wed, 20 Jan 2016 20:23:00 +0000

Myocarditis can be brought by a wide range of infectious and non-infectious causes. Mostly (in up to 95% cases) it is caused by some of virus, less often by bacterium, parasites (mainly in South and Central America) and rarely by fungus, toxins and drugs (in this case we talk about so called hypersensitive eosinophilic myocarditis) or myocarditis is a consequence of other, mostly autoimmune diseases. It is difficult to describe all infectious causes (virus, bacterium, and parasite) of myocarditis, because the disease can be induced by huge amount of causes. It makes diagnosis and treatment harder. Mostly it is about viruses, causing infection of the respiratory system and alimentary canal. In the following table, you can find some examples of infectious and non-infectious cases. The most frequent of them are highlighted. There are also mentioned diseases in brackets, which are brought about by these causes and which are more frequent and known. Alternatively, there are mentioned even abbreviations and notes.

VIRUSES	BACTERIUM	PARASITES AND PROTOZOANS	FUNGI
Enteroviruses: Coxsackie A, B; echoviruses, polioviruses (eg. Infections of respiratory system, heart and nervous system)	Borrelia (most often burgdorferi; Lyme disease)	Toxoplasma gondii (toxoplasmosis transmitted mostly by cats)	Candida
Adenoviruses (infections of respiratory system and alimentary canal including diarrhoeal diseases)	Streptococcus (a lot of species, commonly occurring in human body, in some situations could cause pneumonia and meningitis)	Trypanosoma cruzi (causing Chagas disease, mostly in S. America)	Cryptococcus (transmitted by bird´s droppings)
Influenza virus	Stafylococcus (tens of species, causing mostly inflammations)	Plasmodium falciparum (malaria)	Histoplasmosis (transmitted by bird´s and bat´s droppings)
Cytomegalovirus (CMV; infectious mononucleosis etc.)	Mycobacterium (eg. tuberculosis)	Trichinella spiralis (causing trichinelosis, induced eg. by Trichinella spiralis)	Aspergillus (occurs at patients with immunodeficiency and lungs diseases)
Parvovirus B19 (exanthematous diseases, aplastic anemia etc.)	Chlamydiee: mostly Chlamydiae pneumoniae – lung (pneumoniae causes eg. pneumoniae)	Schistosomosis (parasitic disease of urinary and venereal system, alternatively of liver and intestines)	Actinomyces (causes abscesses – cavities filled with pus, and fibrosis)
Herpes simplex virus 6 (so called 6^th disease)	Mycoplasma pneumoniae (respiratory system infections)	Toxocara canis
Epstein-Baar Virus (EBV infectious mononucleosis, chronic tiredness syndrome)	Legionella (respiratory system infections)
HIV	Corynebacterium diptheriae (causing diphtheria, diseases of myocardium and peripheral nerves)
Hepatitis C virus (hepatitis)
Myxoviruses (belong to virus family causing mumps, measles etc., influenza virus also included
Rubella („Three-day measles“)
Varicella zoster virus (chickenpox, herpes zoster)

TOXINS	DRUGS	DISEASES (MOSTLY AUTOIMMUNE)
Alcohol	Antibiotics (penicillin, sulfonamides, tetracyclines, cefalosporines, streptomycine)	Systemic lupus erythematosus (SLE)	Churg-Strauss syndrome
Antracyclines	Antidepressants (tricyclic, clozapine, benzodiazepine etc.)	Sarcoidosis	Smallpox vaccination (special situation years ago)
Cocaine	Antituberculosis drugs léky (isoniazid, Para-Amino-Butyric acid) a anticonvulsants (phenytoin)	Kawasaki disease	Giant-cell myocarditis
Anabolic steroids	Snake, spider venom	Rheumatic fever/ rheumatoid arthritis	Hypereosinophilic syndrome
Heavy metals (cobalt, lead); carbon oxide	Bee, wasp´s venom	Celiac disease
	Some diuretics (acetazolamide, chlorthalidone, spironolactone, hydrochlorothiazide etc.)	Wegener granulomatosis
	Nonsteroidal anti-inflammatory drugs (indometacin, phenylbutazone, ibuprofen)	Sjögren´s syndrome
	Dobutamine; methyldopa

Author of the opening picture: Thomas Splettstoesser

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Causes (Etiology)