Hostname: page-component-586b7cd67f-r5fsc Total loading time: 0 Render date: 2024-11-24T14:12:10.706Z Has data issue: false hasContentIssue false
  • English
  • Français

Meningitis and high-grade, second-degree atrioventricular block in an adolescent: causal effect or coincidence?

Part of: Infectious Electrophysiology

Published online by Cambridge University Press:  10 May 2021

Lee D Murphy ,
Amy R Florez ,
Richard J Czosek ,
David S Cooper  and
Kenneth E Mah Open the ORCID record for Kenneth E Mah [Opens in a new window]
Lee D Murphy
Affiliation:
The Heart Institute, Division of Cardiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
Amy R Florez
Affiliation:
The Heart Institute, Division of Cardiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
Richard J Czosek
Affiliation:
The Heart Institute, Division of Cardiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
David S Cooper
Affiliation:
The Heart Institute, Division of Cardiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
Kenneth E Mah*
Affiliation:
The Heart Institute, Division of Cardiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
*
Author for correspondence: Kenneth E. Mah, MD, MS, The Heart Institute, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, MLC 2003, Cincinnati, OH45229, USA. Tel: (513) 803-4343; Fax: (513) 636-3952. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

We describe an adolescent with Streptococcus pneumoniae meningitis and symptomatic high-grade, second-degree atrioventricular block requiring permanent pacemaker placement. It is difficult to ascertain if these two diagnoses were independent or had a causal relationship though ongoing symptoms were not present prior to the infection. Because of this uncertainty, awareness that rhythm disturbances can be cardiac in origin but also secondary to other aetiologies, such as infection, is warranted.

Keywords

High-grade heart blocksecond-degree atrioventricular blockStreptococcus pneumoniae meningitisseizurepacemakershock (circulatory)
Type
Brief Report
Information
Cardiology in the Young , Volume 31 , Issue 11 , November 2021 , pp. 1873 - 1875
Check for updates
Copyright
© The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Baruteau, A-E, Pass, RH, Thambo, J-B, et al. Congenital and childhood atrioventricular blocks: pathophysiology and contemporary management. Eur J Pediatr 2016; 175: 1235–1248.CrossRefGoogle ScholarPubMed
Etherington, J, Salmon, J, Ratcliffe, G Atrio-ventricular dissociation in meningococcal meningitis. J R Army Med Corps 1995; 141: 169–171.CrossRefGoogle ScholarPubMed
De l’Etoile-Morel, S, Feteih, A, Hogan, CA, Vinh, DC, Thanassoulis, G Case of reversible complete heart block. Am J Med 2017; 130: e335–e336.CrossRefGoogle ScholarPubMed
Morriss, JH, Gillette, PC, Barrett, FF Atrioventricular block complicating meningitis: treatment with emergency cardiac pacing. Pediatrics 1976; 58: 866–868.Google ScholarPubMed
Brown, AO, Millett, ER, Quint, JK, Orihuela, CJ Cardiotoxicity during invasive pneumococcal disease. Am J Respir Crit Care Med 2015; 191: 739–745.CrossRefGoogle ScholarPubMed
Chadwick, D, Smith, D The misdiagnosis of epilepsy. Br Med J 2002; 324: 495–496.CrossRefGoogle ScholarPubMed
Kusumoto, FM, Schoenfeld, MH, Barrett, C, et al. 2018 ACC/AHA/HRS guideline on the evaluation and management of patients with bradycardia and cardiac conduction delay. J Am Coll Cardiol 2019; 74: e51–e156.CrossRefGoogle ScholarPubMed
Shenoy, AT, Beno, SM, Brissac, T, et al. Severity and properties of cardiac damage caused by Streptococcus pneumoniae are strain dependent. PLoS ONE 2018; 13: e0204032.CrossRefGoogle ScholarPubMed
Brown, AO, Mann, B, Gao, G, et al. Streptococcus pneumoniae translocates into the myocardium and forms unique microlesions that disrupt cardiac function. PLoS Pathog 2014; 10: e1004383.CrossRefGoogle ScholarPubMed