When infection strikes the heart: identifying and treating non-rheumatic streptococcal myocarditis in a young man with chest pain and concurrent streptococcal pharyngitis

Abstract

Pharyngitis and tonsillitis are common reasons for seeking medical care. While mostly viral, Streptococcus pyogenescauses 5-20% of adult cases. Non-rheumatic streptococcal myocarditis is a distinct form of myocarditis associated with streptococcal infection and has clinical features resembling acute coronary syndrome. It mainly affects young men and can lead to significant complications, including sudden cardiac death. We present a case of a young man with non-rheumatic streptococcal myocarditis that developed three days after streptococcal pharyngitis. This is the first documented case in which a treatment approach using a combination of benzathine phenoxymethylpenicillin, perindopril, and bisoprolol, followed by extended therapy with extencillin, resulted in a rapid improvement in the patient's cardiac function and general health. The insights gained from this case offer valuable guidance for managing similar conditions in the future.