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Article

Neutrophilic Myocarditis: Insights from a Forensic Centre’s Retrospective Study

1
Department of Pathology, University of Medicine and Pharmacy Carol Davila, 050474 Bucharest, Romania
2
Emergency Hospital for Children Grigore Alexandrescu, 011743 Bucharest, Romania
3
National Institute of Legal Medicine Mina Minovici, 042122 Bucharest, Romania
4
National Institute of Endocrinology C.I. Parhon, 011863 Bucharest, Romania
*
Author to whom correspondence should be addressed.
Diagnostics 2024, 14(14), 1527; https://doi.org/10.3390/diagnostics14141527
Submission received: 30 May 2024 / Revised: 27 June 2024 / Accepted: 10 July 2024 / Published: 15 July 2024
(This article belongs to the Special Issue Cardiovascular Diseases: Diagnosis and Management)

Abstract

Background: Neutrophilic myocarditis often stems from bacterial or fungal infections, and it is typically detectable through blood cultures or analyses of the primary infection site. However, research specifically addressing the morphological features of acute myocarditis in complex sepsis cases is scarce, with existing studies primarily dating back to the pre-antibiotic era. Methods: This study constitutes a retrospective and descriptive analysis encompassing 22 forensic cases. We collected data from forensic reports emphasising clinical details, disease history, gross observations, and histopathological findings. Results: The results show that using positive-air-pressure ventilation could be related to cardiac inflammation (45.45%, 10/22). Despite large-spectrum antibiotic therapy, the blood samples were positive for Staphylococcus aureus (MRSA strain), Klebsiella pneumoniae (ESBL strain), Acinetobacter baumannii, and Pseudomonas aeruginosa. Colonies developed in the myocardium of 36% of the patients (8/22), where 4 of them had septic emboli. Fungal myocarditis accompanied bacterial infections (2/8) and were unsuspected clinically. Background changes, such as interstitial fibrosis and arteriosclerosis, were associated with a greater degree of inflammation and septic embolism. Conclusion: Neutrophilic myocarditis in patients with emerging sepsis is linked to fatal virulent infections, where bacteria and/or fungi contaminate and impair the myocardium syncytium. Prolonged hospitalisation and positive-air-pressure ventilation may be a risk factor for this condition and needs further research.
Keywords: myocarditis; sepsis; positive-air-pressure ventilation; neutrophilic cardiac inflammation myocarditis; sepsis; positive-air-pressure ventilation; neutrophilic cardiac inflammation

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MDPI and ACS Style

Neagu, O.; Luca, L.; Bosa, M.; Tița, A.; Ceaușu, M.C. Neutrophilic Myocarditis: Insights from a Forensic Centre’s Retrospective Study. Diagnostics 2024, 14, 1527. https://doi.org/10.3390/diagnostics14141527

AMA Style

Neagu O, Luca L, Bosa M, Tița A, Ceaușu MC. Neutrophilic Myocarditis: Insights from a Forensic Centre’s Retrospective Study. Diagnostics. 2024; 14(14):1527. https://doi.org/10.3390/diagnostics14141527

Chicago/Turabian Style

Neagu, Oana, Lăcrămioara Luca, Maria Bosa, Alina Tița, and Mihail Constantin Ceaușu. 2024. "Neutrophilic Myocarditis: Insights from a Forensic Centre’s Retrospective Study" Diagnostics 14, no. 14: 1527. https://doi.org/10.3390/diagnostics14141527

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