Aortitis and inflammatory myopericardial syndrome after Chlamydia pneumoniae infection – A Case report

Abstract Background Inflammatory myopericardial syndrome (IMPS) is a major disease entity, particularly among younger male patients. The simultaneous occurrence of aortitis is uncommon but potentially life-threatening. Case Summary A 32-year-old male presented with acute tonsillitis, requiring hospitalization due to significant disease progression. During hospitalization, the patient developed dyspnea and angina pectoris. Owing to suspected ST-elevation myocardial infarction, the cardiac catheterization laboratory was activated; however, coronary artery disease was ruled out. Intensive care treatment was initiated due to emerging cardiogenic shock secondary to subsequently diagnosed IMPS. Computed tomography (CT) revealed a fluid halo surrounding the ascending aorta, which, in combination with positron emission tomography (PET)/CT findings, was interpreted as aortitis. As part of the diagnostic investigation, typical causes of IMPS and aortitis were ruled out. However, acute infection with Chlamydia pneumoniae was identified. Following a 10-day course of azithromycin, inflammatory markers resolved, and no residual evidence of IMPS or aortitis was observed on follow-up cardiac magnetic resonance imaging. Discussion In this case report, acute Chlamydia pneumonia infection was the only identifiable factor potentially associated with the simultaneous occurrence of IMPS and aortitis. Further research is needed to elucidate the underlying pathomechanism and therapeutic options.