Myocarditis Etiology
Viral – Coxsackie A, ECHO, Influenza, Entero,
HIV, Adeno, CMV
Chlamydia and Rickettsia
Bacteria – diphtheria, Neisseria, Borrelia
Protozoa – Trypanosoma, Toxoplasma, Trichinella
Hypersensitivity – SLE( Libman Sacks endocarditis), RHD, graft rejection
Drugs: doxorubicin
Physical Agents – Radiation
Idiopathic – Giant cell myocarditis
Myocarditis Morphology
Gross –dilated, flabby heart, pale patches with hemorrhage giving mottled appearance, abscess if bacterial
Microscopic – interstitial inflammatory infiltrate with myocyte necrosis, fibrosis, viral inclusion bodies
Mononuclear cells – idiopathic or viral
Neutrophils – bacterial
Eosinophils –hypersensitivity or protozoa
Granulomatous – TB or sarcoid
Dilated, globoid
heart in
myocarditis
Bacterial colony in myocarditis
Toxoplasmosis
Chagas disease
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