Objective:

To describe the epidemiological, clinical, and microbiological characteristics of patients with myocarditis due to Enterobacteria.

Methods:

A systematic review was carried out on the literature, which included Pubmed, Ovid, Scopus, SciELO, and LILACS, with no exclusions due to language. The target population of the study were patients with a diagnosis of bacterial infection due to gram negative bacillus by means of a culture, or using molecular or histopathology technique. They also had to have had a myocardial biopsy or, if not, a cardiac magnetic resonance scan with findings suggestive of myocarditis.

Results:

Out of a total of 742 articles found, 24 of these, in which 27 patients were described, were included. The mean age was 31 years, and 81% were male. The main symptom was diarrhoea (80%), followed by fever (53%), and chest pain (38%). More than one-third (37%) of the patients died. The most common finding on the electrocardiogram (ECG) was elevation of the ST segment (36.7%). Abnormalities were found in 50% of the cases, on whom a cardiac ultrasound was performed, with a decrease in the ejection fraction being the most common.

The most common microorganism was Campylobacter jejuni, followed by Salmonella spp.

Conclusions:

Myocarditis caused by enterobacteria is most common in young male patients. The gastrointestinal symptoms are usually present from the clinical onset. The diagnosis requires a high clinical suspicion, taking into account that the abnormalities in the ECG and cardiac ultrasound are not found in all patients.

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