DOI: 10.12890/2025_005354
Acute non-rheumatic myocarditis following group G streptococcal pharyngitis: a rare mimic of acute myocardial ischemia in a young adult
Authors
erimsky@northwell.edu
Keywords
Streptococcal pharyngitis acute myocarditis (SPAM), group G streptococcus (GGS), pharyngitis, cardiac magnetic resonance, non-rheumatic myocarditisAbstract
Background: Acute myocarditis is a rare but serious inflammatory condition of the myocardium, often triggered by infections or rheumatic heart disease. While group A Streptococcus is commonly associated with bacterial myocarditis, group G Streptococcus is rarely implicated. This case highlights a rare instance of non-rheumatic acute myocarditis also known as Streptococcal pharyngitis acute myocarditis caused by group G Streptococcus in a 19-year-old male without rheumatic fever.
Case report: A previously healthy 19-year-old male presented with chest pain, fever, and sore throat, prompting hospitalization. The diagnosis of acute myocarditis was based on elevated cardiac biomarkers, electrocardiographic abnormalities, and cardiac magnetic resonance imaging, with group G Streptococcus infection confirmed by throat polymerase chain reaction. The patient responded well to antibiotics and anti-inflammatory therapy.
Conclusions: This case highlights group G Streptococcus-induced pharyngitis acute myocarditis, stressing the need for prompt diagnosis and treatment in young adults presenting with recent streptococcal pharyngitis.
References
- Karthikeyan G, Guilherme L. Acute rheumatic fever. The Lancet 2018;392:161–174.
- Aguirre JL, Jurado M, Porres-Aguilar M, Olivas-Chacon C, Porres-Muñoz M, Mukherjee D, et al. Acute nonrheumatic streptococcal myocarditis resembling ST-elevation acute myocardial infarction in a young patient. Proc (Bayl Univ Med Cent) 2015;28:188-190.
- Upadhyay GA, Gainor JF, Stamm LM, Weinberg AN, Dec GW, Ruskin JN. Acute Nonrheumatic Streptococcal Myocarditis: STEMI Mimic in Young Adults. Am J Med 2012;125:1230–1233.
- Schmutzler L, Mirna M, Hoppe UC, Lichtenauer M. From Streptococcal Pharyngitis/Tonsillitis to Myocarditis: A Systematic Review. J Cardiovasc Dev Dis 2022;9:170.
- Kalpakos T, Wilgenhof A, Michiels V, Cosyns B, Vermeersch P. Streptococcal pharyngitis associated myocarditis (SPAM): the perfect ST-segment elevation myocardial infarction (STEMI) mimic in young individuals. A case series. Acta Cardiol 2021;76:449-454.
- O’Brien CE, Coulson JD, Sekar P, Resar JR, Nelson McMillan K. Non-rheumatic streptococcal myocarditis mimicking acute myocardial infarction in an adolescent male. Cardiol Young 2018;28:454-457.
- Eichhorn C, Greulich S, Bucciarelli-Ducci C, Sznitman R, Kwong RY, Gräni C. Multiparametric Cardiovascular Magnetic Resonance Approach in Diagnosing, Monitoring, and Prognostication of Myocarditis. JACC Cardiovasc Imaging 2022;15:1325-1338.