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An immunosuppressed 37-year-old woman with right atrial necrotising myocarditis
  1. Sinead Carlson,
  2. Mary Nangrahary and
  3. Jeremy SL Ong
  1. Cardiovascular Medicine, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
  1. Correspondence to Dr Sinead Carlson; sinead.carlson{at}


A 37-year-old immunocompromised woman was admitted with palpitations, fevers and myalgias. An echocardiogram demonstrated a mass in the right atrial walls and interatrial septum. Endovascular biopsy of the myocardium revealed neutrophilic necrotising myocarditis isolated to the right atrium. Multiple blood, urine and stool cultures were negative but a high anti-streptolysin O antibody titre was detected. The combination of these findings led to the working diagnosis of necrotising myocarditis. Without a positive culture, it was not possible to definitively state the cause of this condition. She was treated with intravenous antibiotics and continued to improve physically and biochemically on discharge.

  • cardiovascular medicine
  • infectious diseases

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  • Contributors All authors have contributed to this manuscript. SC for the writing of the manuscript, MN contributed to editing and JO for the images with descriptions.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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