Systemic and cardiac infections are usually self-limiting, occasionally they cause death in a few days, and less frequently, tissue changes may follow the initial disease leading to continuing disability. Saphir1,2,3 reported myocardial inflammation in 4% of patients who died of various infectious diseases and in about 10% when many histological sections were examined carefully. In the early 19th century, Corvisart4 recognized acute carditis as a fatal illness and also one capable of smoldering as a "chronic organic disease mortal in all cases." Coxsackie infection of the newborn5,6 and influenza7 produce types of myocarditis rapidly fatal in a few days, and diphtheria as well as rheumatic fever may lead to extensive myocardial fibrosis and death. There are variable clinical patterns of these two extremes.
Bacteria may injure tissues directly or the inflammatory reaction which they provoke may cause transient abnormalities. Certain bacterial toxins (clostridia, Corynebacterium diphtheriae) are
Woodward TE, Togo Y, Lee Y, Hornick RB. Specific Microbial Infections of the Myocardium and Pericardium: A Study of 82 Patients. Arch Intern Med. 1967;120(3):270–279. doi:10.1001/archinte.1967.00300030012004
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