Guest guest Posted January 2, 2006 Report Share Posted January 2, 2006 Date: Thu Sep 15, 2005 8:53 am Subject: Mycoplasma Myocarditis 71 Medical journal articles and abstracts from Entrez PubMed Mycoplasma Myocarditis 71 Medical journal articles and abstracts from Entrez PubMed http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=search & DB=pubmed 1: [Extrapulmonary infections due to Mycoplasma pneumoniae] [Article in French] Garnier JM, Noel G, Retornaz K, Blanc P, Minodier P. Hopital nord de Marseille, assistance publique-hopitaux de Marseille, chemin des Bourrely, 13915 Marseille cedex 20, France. jean- marc.garnier@... Arch Pediatr. 2005 Apr;12 Suppl 1:S2-6. Pneumonia is the main site of infection with Mycoplasma pneumoniae in paediatric age. Nevertheless it can also give rise to other manifestations, with or without respiratory involvement. In the present review are described some unusual clinical features of M. pneumoniae in children. Encephalitis and meningoencephalitis is the most frequent neurological manifestation, but cases of meningitis, myelitis, and polyradiculitis, have been reported. Cardiac involvement is potentially severe, including pericarditis and myocarditis. Cold agglutinin haemolytic anaemia is the most frequent haematologic manifestation. Skin, renal, gastro-intestinal, osteoarticular, and other manifestations have also been reported in the literature. The pathogeny of these extrapulmonary infections is not fully elucidated and the treatment remains partly controversial. Extrapulmonary complications can occur as a result of direct invasion and/or autoimmune response. 2: Association of drowning and myocarditis in a pediatric population: an autopsy-based study. Somers GR, CR, GJ, Zielenska M, Tellier R, GP. Division of Pathology, Department of Pediatric Laboratory Medicine, Hospital for Sick Children, Toronto, Ontario, Canada. gino.somers@... Arch Pathol Lab Med. 2005 Feb;129(2):205-9. CONTEXT: Drowning is a frequent cause of accidental death in childhood, but the association of myocarditis and drowning has only rarely been reported. OBJECTIVE: To report 5 cases of drowning in children with coexistent myocarditis. DESIGN: A retrospective review of autopsy records of patients 0 years to 18 years of age was performed during a 6-year period (1998-2003, total cases reviewed = 1431). RESULTS: Twenty-two drownings were identified, in 14 male and 8 female children. Five patients (23%), 3 female and 2 male children, had coexistent myocarditis. The 5 patients ranged in age from 23 months to 13 years (mean, 7 years 2 months). None of the patients had antecedent symptomatology suggestive of myocarditis. In all patients, the myocarditis was focal mild or moderate, and the inflammatory infiltrate comprised lymphocytes with smaller numbers of neutrophils. All 5 patients had foci of myocyte necrosis. One patient had histologic evidence of myocardial hypertrophy but no evidence of a cardiomyopathy. Microbiologic studies, including culture, immunohistochemistry, polymerase chain reaction, and reverse transcriptase polymerase chain reaction, revealed Mycoplasma pneumoniae DNA in 1 case. CONCLUSIONS: The finding of myocarditis in a significant proportion of drowning victims in this series highlights the importance of a thorough autopsy examination in apparently straightforward cases and has clinicopathologic significance. 3: Trypanosoma cruzi trans-sialidase as a new therapeutic tool in the treatment of chronic inflammatory diseases: possible action against mycoplasma and chlamydia. de Lourdes Higuchi M. Pathology Laboratory, Heart Institute (InCor) of Clinical Hospital, School of Medicine of Sao o University, Av. Dr Eneas de Carvalho Aguiar 44, 05403-000 Sao o, SP, Brazil. anplourdes@... Med Hypotheses. 2004;63(4):616-23. The present paper proposes a new therapy using Trypanosoma cruzi trans-sialidase to treat diseases with unclear pathogenesis that present in common chronic inflammation and fibrosis. This hypothesis is based on recent findings that co-infection with mycoplasma and chlamydia is present in many of these diseases and that this enzyme was capable to eliminate or decrease the co- infection from the host. We identified that mycoplasmas and chlamydias are present in atherosclerosis, aortic valve stenosis, dilated cardiomyopathy, chronic chagasic myocarditis and cancer. We hypothetized that mycoplasmal infection may induce immunodepression in the host, favoring proliferation of pre-existent chlamydial infection and that elimination of mycoplasma would lead to improvement of the immune system resistance and the control of chlamydial proliferation. Mycoplasma has a particular parasitic relationship with host cells, involving strong adherence of their membranes, making it extremely difficult to eradicate mycoplasmal infection from the host. A new therapeutic approach is suggested using one or more agents that prevent or inhibit the adherence of mycoplasma to host cell membranes by removing sialic acid residues and preventing oxidation of the cells. The use of a neuraminidase enzyme, particularly the T. cruzi trans-sialidase enzyme, associated with treatment using anti-oxidating agents is proposed. Preliminary experimental animal and laboratory tests showed good results. The proposal that trans-sialidase from T. cruzi is efficient in combating co-infection of mycoplasma and chlamydia is based, at least in part, on the observation that chagasic patients suffering from T. cruzi infection present less mycoplasma and chlamydia infection in their tissues. Also, a lower incidence of the diseases above described to be related to mycoplasma infection is observed in chagasic patients. It is also hypothesized that co-infection with mycoplasma and chlamydia may induce oxidation of the host cells. Anti-oxidants such as those present in plant extracts may also be used in the treatment. Other diseases such as chronic hepatitis, glomerulonephritis, Multiple Sclerosis, Alzheimer's Syndrome and idiopathic encephalitis are other examples of chronic diseases where mycoplasma and chlamydia might be present, as they have the characteristics of unknown etiology, persistent chronic inflammation and fibrosis. Copyright 2004 Elsevier Ltd. 4: Immunohistochemical study of Hemophilus somnus, Mycoplasma bovis, Mannheimia hemolytica, and bovine viral diarrhea virus in death losses due to myocarditis in feedlot cattle. Haines DM, Moline KM, Sargent RA, JR, Myers DJ, Doig PA. Department of Veterinary Microbiology, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskathewan S7N 5B4, Canada. hainesd@... Can Vet J. 2004 Mar;45(3):231-4. The purpose of this study was to determine the presence of Hemophilus somnus, Mycoplasma bovis, Mannheimia hemolytica, and bovine viral diarrhea virus (BVDV) in lesional tissues of feeder calves dying with myocarditis. Tissues from the heart and lungs of 92 calves dying with myocarditis in Alberta feedlots were immunohistochemically stained for the antigens of these agents. Tissues from 44 calves dying from noninfectious causes and 35 calves dying with pneumonia were tested as controls. Hemophilus somnus was found in cardiac lesions in the majority of myocarditis cases (70/92). Mycoplasma bovis was concurrently demonstrated in the hearts of 4/92 affected calves. No bacterial pathogens were found in heart tissues from the control groups of calves. Bovine viral diarrhea virus was demonstrated in the tissues of 4/92 myocarditis cases compared with those of 13/35 calves dying from pneumonia and 0/44 calves dying from noninfectious causes. The results demonstrate that H. somnus is the principle pathogen associated with myocarditis in feedlot calves and that the presence of BVDV is more common in these calves compared with calves dying of noninfectious causes. The findings also suggest that BVDV is an important pathogen in calves dying with gross postmortem lesions of pneumonia. 5: Magnetic resonance imaging in acute myocarditis: a case report and a review of literature. Geluk CA, Otterspoor IC, de Boeck B, Gevers RM, Velthuis BK, Cramer MJ. Heart Lung Centre Utrecht, department of Internal Medicine, The Netherlands. Neth J Med. 2002 Jun;60(5):223-7. We report a case of acute myocarditis in a 20-year-old male, suggested by the clinical picture, elevated cardiac enzymes, electrocardiography and serology. Diagnosis was confirmed by gadolinium-enhanced MRI showing part of the myocardium affected by an infiltrate. Impaired LV function and wall motion abnormalities were documented by echocardiography and FFE MRI. The patient recovered well within two weeks, but will be followed intensively since dilated cardiomyopathy may ensue. 6: Mycoplasma-associated carditis. Case reports and review. Paz A, Potasman I. Infectious Diseases Unit, Bnai Zion Medical Center and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. Cardiology. 2002;97(2):83-8. We present 2 cases and examine the developments that occurred in diagnosis, treatment, and outcome of 19 additional patients with mycoplasmal peri- and myocarditis. The mean age of this group was 33 years. The final diagnoses were pericarditis (n = 15), myocarditis (n = 5), and myopericarditis (n = 1); pulmonary involvement was noted in 13 patients. Serology established the diagnosis in 12 cases, and isolation in 9 others. In contrast to previous reviews, an echocardiogram was carried out in all patients, thus enabling pericardiocentesis in 13 patients. Antibiotics were given to 19 patients, including 4 who received a newer macrolide. Three patients were left with long-term sequelae, and 1 patient died. The outcome of Mycoplasma carditis has improved over the years, although a minority of patients may suffer long-term sequelae. Copyright 2002 S. Karger AG, Basel 7: [Effect of selenium status on the morbidity of interstitial pneumonia in rats infected with mycoplasma][Article in Chinese] Hu S, Liu X, Yin SA, Cui H. Institute of Nutrition and Food Hygiene, Chinese Academy of Preventive Medicine, Beijing 100050. Wei Sheng Yan Jiu. 1998 Nov 30;27(6):405-8. To investigate the effect of selenium(Se) status on morbidity and process of interstitial pneumonia, we used the Wistar rats as the animal model infected with Mycoplasma Pneumonia (MP). The rats were maintained on the based diets with different doses of Se, infected with MP and exposed to sodium selenite(1.5-2.0 ml/day, containing Se 2 micrograms/ml) or 0.9% NaCl (1.5-2.0 ml/d) by gavage for different time. The experimental rats were divided into five groups, group A, feeding with normal control diet and without infected MP, group B with adequate Se diet and infected MP, group C with Se deficiency diet infected MP and added Se at the same time, group D with Se deficiency diet and added Se after suffered with MP, and group E with Se deficiency diet and infected MP. The results showed that the MP morbidity of the rats fed with high Se diet was significantly lower than that of the rats fed with low Se diet. The pathological change was significant in the low Se group and relatively mild in the high Se group. After infected with MP, the supplementation of sodium selenite to the low Se rats might decrease the MP morbidity and shorten the disease course compared with the group without supplementing Se. The incidence of myocarditis in the infected group with normal Se level diet or in the infected group with Se supplement was lower than that in the group without Se supplementation. The concentrations of Se in plasma and glutathione peroxidase in plasma and white blood cells decreased to a certain level after infection. The present study indicated a positive influence of Se supplement on the morbidity, disease course, and state of interstitial pneumonia in rats. 8: Pathology of experimental mycoplasmosis in American alligators. Brown DR, Nogueira MF, Schoeb TR, Vliet KA, RA, Pye GW, son ER. Department of Pathobiology, College of Veterinary Medicine, University of Florida, Gainesville, Florida 32611, USA. brownd@... J Wildl Dis. 2001 Oct;37(4):671-9. Mycoplasma alligatoris was the suspected etiology of an epidemic of acute multisystemic inflammatory disease which emerged in captive American alligators (Alligator mississippiensis) in Florida (USA) in 1995. In an experimental inoculation study conducted from April through October 1999, 18 alligators were inoculated with 10(2), 10(4), or 10(6) colony forming units (CFU) of M. alligatoris by instillation into the glottis. As early as 1 wk post-inoculation (PI), mycoplasma were cultured from blood of three of six alligators inoculated with 10(6) CFU. Two of those died and the third was euthanatized within 4 wk PI. Necropsy gross findings included fibrinous polyserositis and polyarthritis. Histopathologic changes in affected individuals included pulmonary edema, interstitial pneumonia, pericarditis, myocarditis, meningitis, and synovitis. Mycoplasma were cultured quantitatively in high numbers from trachea, lung, coelomic cavity, liver, spleen, interior of pericardial sac, heart, blood, brain, and limb joints. In alligators inoculated with 10 (6) CFU, heterophilia and moderate hyperglycemia peaked about 4 wk PI, and seroconversion occurred by 6 to 8 wk PI. Necropsy gross and histologic findings were generally unremarkable for the surviving alligators inoculated with 10(6) CFU, alligators inoculated with 10 (2) or 10(4) CFU, and four uninoculated control alligators. Mycoplasma were not cultured at any time point from those alligators. The findings confirm that M. alligatoris can cause fulminant inflammatory disease and rapid death of alligators. 9: Intravenous gamma-globulin therapy in myocarditis complicated with complete heart block: Report of one case. Tsai YG, Ou TY, Wang CC, Tsai MC, Yuh YS, Hwang B. Departments of Pediatrics, Tri-Service General Hospital & National Defense Medical Center, Taipei, Taiwan, Taipei, Taiwan. Acta Paediatr Taiwan. 2001 Sep-Oct;42(5):311-3. Myocarditis complicated with complete heart block is rare in childhood. We report a case of 4-year-old child presented with complete heart block which may have been caused by Mycoplasma pneumoniae. Under emergent temporal pacing, patient experienced cardiogenic shock with pulmonary edema eventually. The cardiopulmonary function was improved with atrial rhythm at the 6th hour later after intravenous infusion with high-dose gamma-globulin (IVIG). The IVIG therapy may have immunomodulatory effects and serve as a potential adjunctive therapy for fulminant myocarditis. 10: Spectrum of clinical and radiographic findings in pediatric mycoplasma pneumonia. SD, Ramanathan J, Swischuk LE. Department of Radiology, University of Texas-Houston Medical School, 6431 Fannin-MSB2.100, Houston, TX 77030, USA. susan.d.john@... Radiographics. 2001 Jan-Feb;21(1):121-31. Clinical symptoms in mycoplasma infection are nonspecific. Pulmonary involvement may be widespread or focal and segmental and is accompanied by signs including rales, rhonchi, and decreased breath sounds. Although manifestations of mycoplasma infection are usually confined to the respiratory tract, a wide variety of extrarespiratory manifestations can also occur, including more severe associated diseases such as myocarditis, acute disseminated encephalomyelitis, and cerebral arteriovenous occlusion. The radiographic findings in mycoplasma pneumonia are also nonspecific and in some cases closely resemble those seen in children with viral infections of the lower respiratory tract. Focal reticulonodular opacification confined to a single lobe is a radiographic pattern that seems to be more closely associated with mycoplasma infection than with other types of pediatric respiratory illnesses, and the diagnosis of mycoplasma pneumonia should be considered whenever focal or bilateral reticulonodular opacification is seen. Hazy or ground-glass consolidations frequently occur, but dense homogeneous consolidations like those seen with bacterial pneumonias are uncommon. Atelectasis or transient pseudoconsolidations due to confluent interstitial shadows are often seen. Radiographic findings alone are not sufficient for the definitive diagnosis of mycoplasma pneumonia, but in combination with clinical findings they can significantly improve the accuracy of diagnosis in this disease. 11: Rhabdomyolysis associated with infection by Mycoplasma pneumoniae: a case report. Berger RP, Wadowksy RM. Pediatrics. 2000 Feb;105(2):433-6. BACKGROUND. Mycoplasma pneumoniae is responsible for approximately 20% of the cases of community-acquired pneumonia. The onset of respiratory symptoms is gradual and systemic complaints such as headache, malaise, arthalgias, and low-grade fever are frequently prominent. Extrapulmonary manifestations of M pneumoniae are common and hematologic (thrombocytopenia, splenomegaly, disseminated intravascular coagulation, hemolytic anemia), dermatologic (s- syndrome), gastrointestinal (vomiting, diarrhea, pancreatitis), renal (interstitial nephritis, glomerulonephritis), cardiac (pericarditis, myocarditis, pericardial effusion) and central nervous system (meningitis, transverse myelitis, polyradiculopathy, cerebellar ataxia, sensorineural hearing loss) complications can occur. OBSERVATION. We describe the case of an adolescent girl with massive rhabdomyolysis associated with an infection caused by M pneumoniae. We briefly review the differential diagnosis of a patient presenting with acute rhabdomyolysis and discuss the use of a new polymerase chain reaction-based assay for direct detection of M pneumoniae in throat swab specimens. CONCLUSION. Clinicians should be aware of a possible association between rhabdomyolysis and infection with M pneumoniae and should consider testing for M pneumoniae when they are presented with a patient with idiopathic rhabdomyolysis. The new polymerase chain reaction-based assay for detection of M pneumoniae is a more accurate and more efficient method than traditional culture. 12: Endocarditis and myocarditis caused by Mycoplasma] [Article in Japanese] Morimoto S. Department of Internal Medicine, Fujita Health University School of Medicine. Ryoikibetsu Shokogun Shirizu. 1999;(24 Pt 2):244-8. 13: [Carditis associated with Mycoplasma pneumoniae infection. Clinical aspects and therapeutic problems][Article in Italian] Prattichizzo FA, Simonetti I, Galetta F. Unita Operativa di Medicina Interna, San Miniato (PI), Azienda USL 11, Empoli. Minerva Cardioangiol. 1997 Sep;45(9):447-50. A clinical case of carditis associated with Mycoplasma pneumoniae infection in a 65 year-old woman is reported in order to stress some clinical features and therapeutic problems; during a 5- year follow-up. On the basis of this experience it is possible to state that in the pathogenesis an autoimmune mechanism probably plays an important role, whereas in therapy specific antibiotics are not effective and a long-term treatment with anti-inflammatory drugs is necessary. 14: [intrapericardial hemorrhage as a manifestation of mycoplasma pneumoniae infection][Article in German] Hofner G, Hofbeck M, Koch A, Schmiedl N, Singer H. Klinik mit Poliklinik fur Kinder und Jugendliche Universitat Erlangen- Nurnberg. Z Kardiol. 1997 Jun;86(6):423-6. Although carditis associated with Mycoplasma pneumoniae is infrequent it is an important cause of death in M. pneumoniae infections. We report on a 4-year-old boy with a M. pneumoniae infection, who developed a large hemorrhagic pericardial effusion and was successfully treated by percutaneous catheter drainage. Except in cancer patients, nontraumatic hemorrhagic pericardial effusions are rare. Our case strongly supports direct bacterial invasion into pericardial tissue as a cause of M. pneumoniae pericarditis rather than autoimmune phenomenon. 15: Severe pleuropneumonia without a cough and myocarditis with mixed mycoplasma infection. Chang AB, O'Duffy J, Ratcliffe J, Radford D, Masters IB. J Paediatr Child Health. 1996 Dec;32(6):546-7. 16: The organisms reported to cause infective myocarditis and pericarditis in England and Wales. Fairley CK, M, Wall PG, Weinberg J. Public Health Laboratory Service, Communicable Disease Surveillance Centre, London, U.K. J Infect. 1996 May;32(3):223-5. Comment in: J Infect. 1997 Mar;34(2):155. It is difficult to acquire an overall perspective of the range of organisms responsible for infective myocarditis or pericarditis, and their relative importance, as most studies have involved only case reports or case series of a single organism. This study analyses reports to the Communicable Disease Surveillance Centre, of the Public Health Laboratory Service. Reports where myocarditis or pericarditis was included as the main clinical features between 1990 and 1993 were studied. Between 1990 and 1993, 368 cases of myocarditis and/or pericarditis were reported to CDSC. Viruses were reported to cause 253 (69%) cases, bacteria were responsible for 49 (13%) cases, mycoplasma for 32 (9%) cases, chlamydia for 16 (4%) cases and Mycobacterium tuberculosis for nine (2%) cases. Infection with coxsackie B virus was most frequently associated with a mixed picture of myo/pericarditis, whereas influenzae virus was associated with pericarditis or myocarditis alone. This information will provide clinicians with details of the more likely pathogens responsible for these conditions. 17: [Myocarditis caused by Mycoplasma][Article in Japanese] Morimoto S. Department of Internal Medicine, Fujita Health University School of Medicine. Ryoikibetsu Shokogun Shirizu. 1996;(14):211-4. 18: [The differentiation of the antigens making up the circulating immune complexes][Article in Russian] Gorina LG, Vul'fovich IuV. Gamaleya Research Institute of Epidemiology and Microbiology, Moscow, Russia. Zh Mikrobiol Epidemiol Immunobiol. 1996 Jan-Feb;(1):58-61. A simple method for the detection and analysis of circulating immune complexes (CIC) in specimens of biological fluids is proposed. The method was approved in the examination of patients with chronic infections caused by mycoplasmas and Streptococcus pyogenes L-forms. The method made it possible to diagnose infectious diseases accompanied by the formation of immune complexes and to study the dynamics of the processes of the accumulation and elimination of CIC in the course of the disease. Thus, the detection rate of specific antigens (Ag) incorporated into CIC in patients with mycoplasmal pneumonia exceeded 90 %. In children aged up to 1 year this rate decreased to 40 %. The diagnostic value of the determination of specific Ag incorporated into CIC was shown in streptococcal infections caused by S.pyogenes L-forms, viz. in frequently relapsing erysipelas, as well as in subacute rheumatism and in infectious allergic myocarditis. 19: Advanced atrioventricular block associated with atrial tachycardia caused by Mycoplasma pneumoniae infection. Umemoto M, Fujii I, Take H. Department of Pediatrics, Kagoshima City Hospital, Japan. Acta Paediatr Jpn. 1995 Aug;37(4):518-20. Atrial tachycardia with atrioventricular (AV) block has been recognized as a common manifestation of digitalis toxicity. We describe here an unusual case of transient advanced AV block associated with atrial tachycardia in a 6 year old boy with evidence of Mycoplasma pneumoniae infection. 20: Streptococcus suis infection in swine: a retrospective study of 256 cases. Part II. Clinical signs, gross and microscopic lesions, and coexisting microorganisms. Reams RY, Glickman LT, Harrington DD, Thacker HL, Bowersock TL. Indiana Animal Disease Diagnostic Laboratory, West Lafayette. J Vet Diagn Invest. 1994 Jul;6(3):326-34. A retrospective study of 256 cases of naturally acquired Streptococcus suis infections in swine submitted to the Indiana Animal Disease Diagnostic Laboratory from 1985 to 1989 was undertaken to describe the clinical signs, lesions, and coexisting organisms associated with S. suis serotypes 1-8 and 1/2. Infected pigs generally had clinical signs and gross lesions referable to either the respiratory system or to the central nervous system (CNS), but not both. Neurologic signs were inversely related to gross lesions in the respiratory tract (R2 = -0.19, P = 0.003), as were respiratory signs and gross lesions in the CNS (R2 = -0.19, P = 0.003). Suppurative bronchopneumonia was the most common gross lesion observed (55.2%, overall). Fibrinous and/or suppurative pleuritis, epicarditis, pericarditis, arthritis, peritonitis, and polyserositis were also reported. In 68% of the pigs, other bacteria in addition to S. suis were isolated. Escherichia coli (35.0%) and Pasteurella multocida (30.0%) were the most commonly recovered bacterial agents. Mycoplasma and viral agents were identified less often, and their role in the development of streptococcosis was difficult to assess. In pigs infected with serotypes 2-5, 7, 8, and 1/2, suppurative meningitis with suppurative or nonsuppurative encephalitis, suppurative bronchopneumonia, fibrinopurulent epicarditis, multifocal myocarditis, and cardiac vasculitis were the most common microscopic lesions observed, whereas pigs infected with serotype 1 generally presented with suppurative meningitis and interstitial pneumonia. Microscopic lesions were morphologically similar among serotypes and were also similar to those reported with other pyogenic bacteria. (ABSTRACT TRUNCATED AT 250 WORDS) 21: Complete heart block from mycoplasma pneumoniae infection. Agarwala BN, Ruschhaupt DG. Division of Pediatric Cardiology, University of Chicago, Wyler Children's Hospital, Illinois 60637. Pediatr Cardiol. 1991 Oct;12(4):233-6. Complete heart block (CHB) in infants and children is usually congenital. Nonsurgical acquired CHB is rare. Occasionally, transient acquired CHB is seen in association with viral myocarditis. We describe here an unusual case of transient CHB in a 12-year-old boy with endomyocardial biopsy-proven myocarditis and evidence of Mycoplasma pneumoniae infection. 22: [Myopericarditis associated with pneumonia caused by Mycoplasma pneumoniae][Article in Spanish] Aloy A, Marco A, de M, Alegre D. Enferm Infecc Microbiol Clin. 1991 Apr;9(4):258-9. 23: A loud third heart sound and asymptomatic myocarditis during Mycoplasma pneumoniae infection. Karjalainen J. Central Military Hospital, Helsinki, Finland. Eur Heart J. 1990 Oct;11(10):960-3. A 20-year-old man had a fever and cough due to Mycoplasma pneumoniae pneumonia. He had no heart symptoms, but auscultation revealed an exceptionally loud third heart sound, suggesting cardiac involvement. Marked myocardial enzyme release, serial electrocardiographic ST-T changes, and transient increase in interventricular thickness and inferior wall hypokinesis at echocardiography supported the diagnosis of acute infectious myocarditis. Recovery was quick. This case shows that acute myocarditis with significant myocardial injury may pass without any subjective heart symptoms. 24: Arrhythmogenic right ventricular dysplasia in brother and sister: is it related to myocarditis? Sabel KG, Blomstrom-Lundqvist C, Olsson SB, Enestrom S. Department of Paediatrics, East Hospital, Goteborg, Sweden. Pediatr Cardiol. 1990 Apr;11(2):113-6. Two cases of arrhythmogenic right ventricular dysplasia (ARVD) in siblings are reported. In the boy, 14 years old, the clinical history, ECG, echocardiography, and histopathological findings were consistent with ARVD. Premature ventricular contractions of left bundle branch block (LBBB) pattern were recorded but no ventricular tachycardia (VT). A high titer against mycoplasma and increased concentrations of immunoglobulins were found. Two years after his first admission he died suddenly. Autopsy revealed severe right ventricular (RV) myocardial damage, with fat cell infiltration and collagenous tissue. His sister presented with sustained VT of LBBB pattern 2 years later, at 12 years of age. Vaccination against rubella and signs of upper respiratory illness had preceded the symptoms. During the following 9 days ECGs and serum enzymes indicated the development of left ventricular (LV) infarction. Echocardiography revealed an enlarged RV and a normal LV. After 6 weeks both RV and LV showed akinetic areas and sacculations. We suggest that myocarditis may be a precipitating factor in ARVD, and perhaps the prerequisite for its manifestation. 25: [Hemolytic anemia and myocarditis caused by Mycoplasma pneumoniae infection][Article in Polish] Wroblewska-Kaluzewska M, Kliszczewska-Kacprzak R, Pleskot M. Wiad Lek. 1989 Dec 1;41(23):1603-6. 26: [Extrapulmonary complications in infection caused by Mycoplasma pneumoniae][Article in Polish] Wroblewska-Kaluzewska M. Wiad Lek. 1988 Jun 15;41(12):791-7. 27: Acute myocarditis. Serologic diagnosis, clinical findings and follow-up. Vikerfors T, Stjerna A, Olcen P, Malmcrona R, Magnius L. Department of Infectious Diseases, Orebro Medical Center Hospital, Sweden. Acta Med Scand. 1988;223(1):45-52. In a prospective study, 57 patients with a preliminary diagnosis of myocarditis were investigated. Twenty-four patients were considered to have an acute myocarditis, 14 had a suspected myocarditis, while in 19 patients myocarditis was excluded. Episodes of frequent supraventricular and/or ventricular extrasystoles during hospital stay were seen in 8/24 cases (33%) with myocarditis and in 1/19 cases (5%) without myocarditis. On follow-up 1 month later, no supraventricular extrasystoles were observed in either group. Echocardiographic signs consistent with left ventricular insufficiency were noted in 7/24 cases (29%) with myocarditis, in 1/14 cases (7%) with suspected myocarditis and in no case without myocarditis. With a " routine " serologic test battery covering influenza viruses A and B, adenovirus, sackie virus group B, ECHO viruses, Chlamydia psittaci, Mycoplasma pneumoniae and hemolytic streptococci group A, a possible etiology could be documented in 9/24 cases (38%) with myocarditis and in 4/19 cases (21%) without myocarditis. Enterovirus-specific IgM was detected with solid-phase reverse immunosorbent test (SPRIST) in 12/23 (48%) cases with myocarditis and in 3/16 cases (19%) without myocarditis. In SPRIST- IgM-positive cases, IgM antibodies were detected in 15/20 (75%) of the sera taken on admission. The overall serological results indicated a recent infection in 16/24 cases (67%) with myocarditis and in 5/19 cases (26%) without myocarditis (p less than 0.05). 28:. [Myocarditis and pericarditis caused by Mycoplasma pneumoniae infection][Article in Polish] Wroblewska-Kaluzewska M, Kliszczewska-Kacprzak R, Pleskot M. Pediatr Pol. 1986 Oct;61(10):656-63 29: Carditis associated with Mycoplasma pneumoniae infection. Chen SC, Tsai CC, Nouri S. Am J Dis Child. 1986 May;140(5):471-2. A 16-year-old boy with acute perimyocarditis had serological evidence of Mycoplasma pneumoniae infection. The endomyocardial biopsy specimen showed grade 2 active lymphocytic myocarditis. A T- cell study suggested a cell-mediated immune process in the pathogenesis of carditis. Mycoplasma pneumoniae needs to be considered as a possible cause of acute carditis, and histological findings may influence management. 30: [Viral lesions of the heart][Article in Russian] Variasin VV. Arkh Patol. 1984;46(6):86-9. 31: [Perimyocarditis and glomerulonephritis associated with Mycoplasma pneumoniae pneumonia][Article in Japanese] Inoue R, Mitsutake Y, Takahashi N, Hidaka R, Ikezaki H, Yoshida H, Morizono T, Kawaguchi M, Abe H, Tanikawa K, et al. Kansenshogaku Zasshi. 1983 Apr;57(4):333-8. 32: Etiology of mild acute infectious myocarditis. Relation to clinical features. Karjalainen J, Heikkila J, Nieminen MS, Jalanko H, Kleemola M, Lapinleimu K, Sahi T. Acta Med Scand. 1983;213(1):65-73. The etiology of mild myocarditis, diagnosed on the basis of serial ECG changes during an acute infection, was studied in 126 consecutive conscripts. A fourfold rise in the antibody titers in the paired serum samples was required for a positive etiologic diagnosis. An etiologic diagnosis was made probable in 47% of the patients. Adenovirus was incriminated in 19 patients, vaccinia in 12, influenza A in eight, beta-hemolytic Streptococcus in six, mononucleosis in five and Mycoplasma in three. Chlamydia, influenza B and sackie B4 were each found in two patients; parainfluenza, mumps and adult Still's disease were each found in one patient. The incidence of vaccinia myocarditis was 1/10000 smallpox vaccinations. Clear-cut myopericarditis was usually noted during vaccinia, mononucleosis, Mycoplasma, Chlamydia and sackie B4 infections. Adenovirus and influenza A myocarditis was most often subclinical, being mostly detected only because of ECG screening of patients without cardiac symptoms. Frequent recent ventricular extrasystoles were most often triggered by a beta-hemolytic Streptococcus infection. The etiology of infectious myocarditis seems to reflect the overall profile of viruses and other infective agents in the study population at that particular time. Cardiotrophic viruses such as sackie B only rarely cause myocarditis outside epidemics. 33: [Two cases of mycoplasma pneumoniae carditis with arrhythmia] [Article in Japanese] Ohyanagi M, Mitani Y, Kawai Y, Iwasaki T. Kansenshogaku Zasshi. 1982 Sep;56(9):825-31. 34: [Extrapulmonary manifestations of 'Mycoplasma pneumoniae' (author's transl)][Article in Spanish] Carreras E, Vall Rosello ML, Calvo Verges E, Puig de la Capilla I, Carreras Batlle N. An Esp Pediatr. 1982 Mar;16(3):246-8. Authors present a six year old girl with a 'Mycoplasma pneumoniae' infection who developed neurologic and cardiac complications. Clinic presentation, physical examination and laboratory data are revised. Clinic course was satisfactory and the child was asymptomatic two months later in out-patient control. 35: [Mycoplasma infections][Article in German] Worz U, Besenthal I. Internist (Berl). 1981 Aug;22(8):468-78. 36: Experimental infection of goats, sheep and calves with the large colony type of Mycoplasma mycoides subsp. mycoides. Rosendal S. Vet Pathol. 1981 Jan;18(1):71-81. Goats, sheep and calves were inoculated intravenously with strain Y3343 of the large colony type of Mycoplasma mycoides subsp. mycoides isolated from a goat with polyarthritis. The goats and sheep died of septicemia (one was killed in extremis) within eight days. The goats had leukopenia and granulocytopenia. Coagulopathy was indicated in some goats; the fibrinogen titer, prothrombin and partial thromboplastin times increased with the progress of disease and the number of platelets decreased dramatically in one goat. Goats and sheep had cellulitis at the site of inoculation, pleural hemorrhages, pneumonia, myocarditis, renal infarcts, glomerulitis, adrenal cortical necrosis, enteritis, focal splenic necrosis, polyarthritis and lymphadenitis. Vasculitis and thrombi were seen occasionally, suggesting that vascular changes, perhaps together with coagulopathy, had a role in pathogenesis. One of two experimental calves developed a slight fever, arthritis and minor inflammation of adrenal tissue. Calves seen less susceptible to the mycoplasma organism given intravenously than do goats or sheep. 37: [use of the aggregate hemagglutination reaction for detecting the L-form antigens of group A hemolytic Streptococcus and Mycoplasma] [Article in Russian] Gorina LG, Zheverzheeva IV, Goncharova SA. Lab Delo. 1981;(11):686-8. 38: sackie-B-virus-specific IgM responses in patients with cardiac and other diseases. El-Hagrassy MM, Banatvala JE, Coltart DJ. Lancet. 1980 Nov 29;2(8205):1160-2. An enzyme-linked immunosorbent assay (ELISA) test using polyvalent antigens and antisera was developed to detect sackie-B- virus-specific IgM responses. The sera of 24 of 64 (37.5%) patients with acute pericarditis and 14 of 38 (36%) with acute myocarditis were positive for sackie-B-virus-specific IgM. 4 of 30 (13.3%) patients with acute ischaemic heart disease and 2 of 28 (7.1%) patients with congestive cardiomyopathy were also positive. sackie- B-virus-specific IgM was detected in the sera of 21 of 57 (36.8%) patients with Bornholm disease and 2 of 4 patients with acute-onset juvenile diabetes. sackie-B-virus-specific IgM responses persisted for 6-8 weeks. Sera from patients with chronic valvular heart disease, Mycoplasma pneumoniae infections, and virus infections caused by viruses other than sackie-B viruses were all negative. False-positive results did not occur when sera containing high titres of rheumatoid factor were tested. 39: Isolation of Mycoplasma bovis from a patient with systemic illness. Madoff S, Pixley BQ, DelGiudice RA, Moellering RC Jr. J Clin Microbiol. 1979 Jun;9(6):709-11. Mycoplasma bovis was cultured from the sputum of a patient with lobar pneumonia, psychosis, and probable myocarditis, nephritis, and hemolytic anemia. Although we cannot be certain that this species of mycoplasma was the etiological agent of the patient's acute illness, this case report is of interest because, to the best of our knowledge, it represents the first isolation of M. bovis from a human source. 40: Clinical aspects of nonrheumatic myocarditis in children. Oda T, Hamamoto K, Morinaga H. Jpn Circ J. 1979 May;43(5):433-40. Sixty-eight patients of clinically diagnosed myocarditis, 0-- 15 years of age, were followed up and analyzed. Forty (58.8%) were males. The majority were older than 5 years. Clinical courses were rather mild, chronic and self-limiting at large. Only 1 case had a relation to chronic cariomyopathy. Exertional symptoms (chest pain, chest distress, syncope) were seen in 25 (36.8%). ECG changes were very common: the majority were nonspecific ST elevation, depression or both, mainly in leads II, III, V5 and V6. Positive Master' test, prolonged QTc, widened mean spatial QRS-T angle and various arrhythmias were also observed. Cardiac performance, estimated by echocardiogram and phono-mechanocardiogram was lowered in 41 (60.3%). Large IV sound and large A wave in apexcardiogram were also frequently found. All but 3 patients showed continuous elevation of serum enzymes, namely, LDH, LDH-1/LDH-2, CPK, CPK-MB, HBD and GOT. Etiological evidences were obtained by serological study in 11 cases (16.2%): 2 of sackie B-1, 3 of sackie B-2, 1 of sackie B-4, 2 of mycoplasma pneumoniae, 1 of cytomegalovirus, 1 of ECHO-7 and 1 of rubella. We proposed a criteria for diagnosis of myocarditis as follows: (1) Exertional symptoms. (2) ECG findings. (3) Serum enzyme abnormality. (4) Lowered cardiac performance. (5) Cardiomegaly. (6) Changing character of all signs and symptoms. 41: Respiratory failure secondary to Mycoplasma pneumoniae infection. Fraley DS, FL, Donnelly EJ. South Med J. 1979 Apr;72(4):437-40. Three previously healthy patients presented with bilateral pulmonary infiltrates, hypoxemia, and respiratory failure associated with Mycoplasma pneumoniae infection. None had underlying pulmonary or immune deficiency diseases. One died with dense fibrotic reorganization of the lungs, and another survived after prolonged mechanical ventilatory assistance. Two developed pulmonary superinfections with Pseudomonas aeruginosa. All had extrapulmonary complications: one had Coombs'-positive hemolytic anemia, another myocarditis, and all three had abnormal results of liver function tests, consistent with hepatocellular dysfunction. 42: The occurrence and clinical picture of serologically verified Mycoplasma pneumoniae infections with emphasis on central nervous system, cardiac and joint manifestations. Ponka A. Ann Clin Res. 1979;11 Suppl 24:1-60. 43: Carditis associated with mycoplasma pneumoniae infection. Ponka A. Acta Med Scand. 1979;206(1-2):77-86. Among 560 patients with serologically confirmed Mycoplasma pneumoniae infection, 25 (4.5%) had carditis (19 perimyocarditis, 6 pericarditis). During the acute phase 9 patients required intensive care. After an average of 16 months follow-up 11 patients with no previous signs of heart disease still had cardiac symptoms or signs. Thus carditis associated with M. pneumoniae infection is a serious disease, having cardiac sequelae more often than has hitherto been supposed. The pathogenesis of the carditis associated with M. pneumoniae infection is discussed, including the possibility that in some cases the elevated titre in the complement fixation test is non- specific. A summary is given of the 33 cases previously presented in the literature. 44: A case of myocarditis caused by Mycoplasma pneumoniae. Yamane Y, Kawai C. Jpn Circ J. 1978 Nov;42(11):1279-87. A 16-year-old girl with myocarditis and hepatitis in the course of mycoplasma pneumoniae infection was reported. She had fever and coughed for ten days prior to admission. At the time of admission infiltrations of the left lower lung field were revealed on the chest X-ray films. The ESR was elevated and CRP+6. There were no leukocytosis and anemia, but S-GOT, S-GPT and LDH were moderately increased. On the 11th day of admission VPC in bigeminy appeared and the third sound was heard. Subsequently biphastic and inverted T waves in leads V2 and V3 and flattening of T waves in leads II and aVF appeared. At the same time, the cardiac shadow was enlarged. Antibody titer to mycoplasma pneumoniae increased to more than 1:640 two weeks after admission and then it decreased gradually. The cold agglutinin test was 1:64 on the 8th day of the disease and then it became normal. ASO, antibodies to DNA and immunoglobulins were normal; ANA, Coombs test and LE test were negative. The abnormal ECG- findings were normalized three months later. 45: [Cardiopulmonary manifestations of Mycoplasma pneumoniae infections (author's transl)] [Article in French] Carre JC, Condouret S, Chabanon G, Parayre N, Dufranc P. Nouv Presse Med. 1978 Jul 1-8;7(27):2373-6. Studies to detect the presence of Mycoplasma pneumoniae infection were undertaken in departments of pulmonary medicine, respiratory intensive care, cardiology, between 1973 and 1977. The diagnosis was based upon the complement deviation reaction, with the exclusion or other serological or culture methods. In addition to acute benign pleuropneumonia, 9 cases of severe pulmonary forms were seen: in 4, acute decompensation in the presence of pre-existence chronic insufficiency, and in the other 5 a radiological picture of acute bilateral bronchopneumonia with dyspnoea. Two patients died in a clinical context of progressive coma. Five cardiac forms with a favourable course were diagnosed: one case of acute myocarditis and 4 of acute pericarditis. 46: Disseminated intravascular coagulation and myocarditis associated with Mycoplasma pneumoniae infection. Pickens S, Catterall JR. Br Med J. 1978 Jun 10;1(6126):1526. 47: [Myocarditis in pneumonia caused by Mycoplasma pneumoniae] [Article in French] Shita A, Bernard R, Zissis G. Acta Clin Belg. 1978;33(4):222-6. 48: [Acute hemolysis and myocarditis with Mycoplasma pneumoniae pneumonia (author's transl)] [Article in Hebrew] Reshef R, Moscuna M, Shasha SM. Harefuah. 1977 Nov 15;93(10):295-6. 49: Polyradiculoneuritis and Mycoplasma pneumoniae infection. Holt S, Khan MM, RG, Epstein EJ. Postgrad Med J. 1977 Jul;53(621):416-8. A patient with severe Mycoplasma pneumonia developed polyradiculoneuritis and respiratory failure. The acute phase of the illness was complicated by a myocarditis, and recovery of neurological function was slow. Residual left hemidiaphragmatic paralysis was present 1 year after onset of the illness. 50: Complete heart block in a young child presumably due to mycoplasma pneumoniae myocarditis. Friedli B, Renevey F, Rouge JC. Acta Paediatr Scand. 1977 May;66(3):385-8. The case is described of an 18 months old boy with sudden onset complete heart block, heralded by Stokes- attacks. General signs of viral illness preceded and accompanied the syndrome; this, along with angiographic evidence of poorly contracting left ventricle, led to the diagnosis of non bacterial myocarditis. Serologic tests disclosed a significant rise in antibodies against mycoplasma pneumoniae (1/16 to 1/128). The His-bundle electrogram showed a block above the His-bundle, but fairly widespread damage to the conduction system is suspected. The complete heart block proved to be permanent and a fixed rate pacemaker had to be implanted. 51: Pericarditis and perimyocarditis associated with active Mycoplasma pneumoniae infection. Sands MJ Jr, Satz JE, WE Jr, Soloff LA. Ann Intern Med. 1977 May;86(5):544-8. In 13 patients an association existed from 1970-73 between Mycoplasma pneumoniae infection and acute pericarditis (in eight) or perimyocarditis (in five). In 12 patients the association was moderately probable, with a fourfold rise in complement-fixing antibody titers between acute and convalescent phase sera being noted. In the last patient, a lesser-order association was found using only convalsecent phase serum. The presence of influenza, herpes simplex, sackie B, or adenovirus was excluded by serologic testing. Acute illness was variable, with four patients developing heart failure. Long-term evaluation (mean, 47 months) found eight patients asymptomatic and three symptomatic. Two patients died. Residual effects of the Mycoplasma infection seemed at least partially responsible in one compromised patient and in one who died. Mycoplasma infection should be considered in the presence of acute cardiovascular decompensation, especially when preceded by upper respiratory infection, and added to the possible causes of idiopathic cardiomyopathy. 52: [L forms of bacteria of the family Mycoplasmataceae and the problem of microbial persistence] [Article in Russian] Timakov VD, Kagan GIa. Zh Mikrobiol Epidemiol Immunobiol. 1977 Apr;(4):3-11. 53: Known and newer manifestations by mycoplasma pneumoniae in adults. Altucci P, Catalano G, Abbate GF, Astarita C, Gattoni A, Leonessa V. Boll Ist Sieroter Milan. 1977 Mar 31;56(1):1-6. Although M. pneumoniae is a well recognised respiratory pathogen both in children and in young adults, its infections have shown recently some pathomorphism and may also involve other organ systems. The paper reviews the various clinical syndromes in adults by M. pneumoniae, with particular emphasis on those more unusual and nevertheless seen by us. In this connection the possibility of pleural effusions (with a well defined cytology) associated or not with typical Mycoplasma pneumoniae and of chronic bronchopneumonias eventually evolving even in pulmonary fibrosis is stressed. Moreover, the development of M. pneumoniae respiratory infections during the course or hematological malignancies and their characteristics are described in some detail because of the relative rarity of this kind of infections in the above patients. Finally, some less frequently reported manifestations of M. pneumoniae infections, as hemolytic anemia, hepatitis and others are described and discussed. 54: Myocardial dysfunction and hemolytic anemia in a patient with Mycoplasma pneumoniae infection. Maresh H, Klimek JJ, Quintiliani R. Chest. 1977 Mar;71(3):410-3. A patient with evidence of myocardial abnormalities and hemolytic anemia is described, in whom the responsible pathogen appeared to be Mycoplasma pneumoniae (as indicated by a 64-fold rise in complement-fixation titers, and by a change in cold-agglutinin titers from 1:8 to 1:4,096). Both cardiac and hematologic problems occurred during the recovery phase from pneumonia and were associated with marked deterioration in the patient's clinical status. Electrocardiographic and serum enzymatic changes mimicked the patterns seen in acute myocardial infarction. 55: Severe mycoplasma pneumonia. Holt S, WF, Epstein EJ. Thorax. 1977 Feb;32(1):112-5. A patient who developed who developed a protracted illness following severe mycoplasma pneumonia is described. The acute phase of the infection was complicated by myocarditis and haemolytic anaemia. The respiratory symptoms abated and lung function tests improved with the administration of systemic and inhaled corticosteroids. 56: Viral myocarditis. Lewes D. Practitioner. 1976 Mar;216(1293):281-7. 57: [The presence of cold agglutinins in hemolytic uremic syndrome (author's transl)] [Article in German] Bugajer-Gleitman HE, Balzar E, Lubec G, May L, Weissenbacher G. Padiatr Padol. 1976;11(1):245-53. A boy, 2 years old, developed a HUS after a pneumonitis. He was treated with Heparin, salicylates and recurrent peritoneal dialysis and recovered slowly. The course of the disease was complicated by myocarditis, gastric hemorrhage and severe neurologic disturbances. 7 days after unset of hemolysis a cold agglutinin titer of 1:256 was detected. This fact arises the question whether infection with Mycoplasma pneumoniae and the presence of cold agglutinins in serum could be involved in the development of HUS. The possibility of a viral etiology for this disease is discussed. 58: Myocarditis and severe bilateral bronchopneumonia caused by Mycoplasma pneumoniae. De Vos M, Straeten M, Druyts E. Infection. 1976;4(1 Suppl):60-3. A man with severe bilateral bronchopneumonia and a right lobar consolidation caused by Mycoplasma pneumoniae, had a concurrent myocarditis. The possible aetiology of the patchy pulmonary opacities is discussed. A literature review of cases of myocarditis associated with M.pneumoniae is presented. 59: [Mycoplasma pneumoniae (author's transl)][Article in French] Bonard EC. Schweiz Rundsch Med Prax. 1975 Sep 16;64(37):1169-72. 60: Letter: Symptomless myocarditis and myalgia in viral and Mycoplasma pneumoniae infections. Simon D, Abbott JA. Br Heart J. 1975 Sep;37(9):987-8. 61: Myocarditis associated with Mycoplasma pneumoniae infection. Mackay AD, Watt JB, GR. Practitioner. 1975 Mar;214(1281):390-2. A 48-year-old patient presented with pneumonia and pleural effusion due to Mycoplasma pneumoniae, and subsequently developed pharyngitis and electrocardiographic evidence of myocarditis. The sparse literature on mycoplasma myocarditis is reviewed. The clinical features, electrocardiographic changes and prognosis are discussed. 62: Myocarditis in Mycoplasma pneumoniae pneumonia. Occurrence with hemolytic anemia and extraordinary titers of cold isohemagglutinins. el-Khatib M, Lerner AM. JAMA. 1975 Feb 3;231(5):493-4. 63: Symptomless myocarditis and myalgia in viral and Mycoplasma pneumoniae infections. Lewes D, Rainford DJ, Lane WF. Br Heart J. 1974 Sep;36(9):924-32. 64: [Carditis following Mycoplasma pneumoniae infection][Article in German] Muller WH, Stezner A. Z Gesamte Inn Med. 1974 Feb 15;29(4):164-8. 65: [Recurrent, complicated pneumonia due to Myocplasma Mycoplasma pneumoniae] [Article in French] Fischer G. Rev Med Suisse Romande. 1973 Dec;93(12):979-87. 66: Association of group B coxsackie viruses with cases of pericarditis, myocarditis, or pleurodynia by demonstration of immunoglobulin M antibody. Schmidt NJ, Magoffin RL, Lennette EH. Infect Immun. 1973 Sep;8(3):341-8. 67: Primary atypical pneumonia due to Mycoplasma pneumoniae complicated by haemorrhagic pleural effusion, haemolytic anaemia and myocarditis. Feizi O, Grubb C, Skinner JI, Constantinidou M, WG. Br J Clin Pract. 1973 Mar;27(3):99-101. 68: Unusual complications of primary atypical pneumonia due to M. pneumoniae. Feizi O, Grubb C, Skinner JI, Constandou M, WG. Br Med J. 1971 Dec 18;4(789):751. 69: Symptomless myocarditis and myalgia in viral and Mycoplasma pneumoniae infections. Lewes D, Rainford DJ. Br Heart J. 1971 Jul;33(4):613. 70: Pathogenesis of cardiac lesions in specific-pathogen-free chicken embryos infected with mycoplasma synoviae. Kerr KM, Bridges CH. Am J Pathol. 1970 Jun;59(3):399-408. 71: [Complete auriculo-ventricular block due to myocarditis caused by Mycoplasma pneumoniae] [Article in French] Rosner P, Eichenberger G, Ferrero C, Koralnik O. Schweiz Med Wochenschr. 1966 Oct 8;96(40):1343-5. * * * * * * * * * * * * * * * * * * * * * * * * * * * FAIR USE: In accordance with Title 17 U.S.C. Section 107, this material is distributed without profit to those who have expressed a prior interest in receiving the included information for research and educational purposes. The Mycoplasma Registry has no affiliation with the originator of this article nor is the Mycoplasma Registry endorsed or sponsored by the originator. If you wish to use copyrighted material from this site for purposes of your own that go beyond 'fair use', you must obtain permission from the copyright owner. * * * * * * * * * * * * * * * * * * * * * * * * * * * Quote Link to comment Share on other sites More sharing options...
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