Typhoid fever may rarely cause a myocarditis, which may progress to a dilated cardiomyopathy. It can be challenging to diagnose early in its course.
Clinical features:
(1) episode of typhoid fever (Salmonella enterica serovar typhi)
(2) chest discomfort
(3) subsequent pulmonary edema and hypoxemia with raised jugular venous pressure and peripheral edema
The ECG may show QT prolongation and T wave inversions.
Echocardiographic changes:
(1) low left ventricular ejection fraction
(2) right ventricular dysfunction
(3) dilation of cardiac chambers (both ventricles and left atrium)
(4) tricuspid and mitral regurgitation
The diagnosis of typhoid cardiomyopathy requires exclusion of other diagnoses.
