Hypersensitivity Myocarditis Associated With Azithromycin Exposure

  1. Amit Pursnani, MD;
  2. Herman Yee, MD;
  3. William Slater, MD; and
  4. Nitasha Sarswat, MD
  1. From New York University School of Medicine, New York, NY 10016, and Albert Einstein School of Medicine, Bronx, NY 10461.

    Background: Myocarditis is a mysterious clinical entity that poses diagnostic and therapeutic challenges. It may be caused by a viral infection or be secondary to inflammation from a bacterial, parasitic, or fungal pathogen. Rarely, it can result from a hypersensitivity allergic reaction to an inciting drug.

    Objective: To report a case of fulminant myocarditis associated with azithromycin exposure.

    Case Report: A 48-year-old man presented to his internist 3 months before admission with an upper respiratory tract infection and was prescribed a course of azithromycin. Within hours of the first dose of azithromycin, the patient developed fever and a diffuse maculopapular rash. He was given oral antihistamines and a 1-week prednisone taper. On completion of the steroid taper, the patient redeveloped fever and rash and, in addition, had fatigue and pruritus. Examination was documented to reveal diffuse lymphadenopathy. Laboratory …

    This 100-word excerpt has been provided in the absence of an abstract.

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