Rickettsial, ehrlichial and Bartonella infections of the myocardium and pericardium.

Myocarditis and pericarditis are uncommon complications of human rickettsial, ehrlichial and Bartonella infections. Myocardial inflammation usually occurs in the setting of acute disseminated infection. Organisms associated with myocarditis include: Rickettsia rickettsii, R. conorii, Orientia tsutsugamushi, Coxiella burnetii, Anaplasma phagocytophila (the causative agent of Human Granulocytic Ehrlichiosis) and Bartonella henselae. Pericarditis has been described in the setting of R. conorii and Coxiella burnetii infections. This article reviews the epidemiology, pathologic characteristics, clinical manifestations, diagnosis and treatment of myocarditis and pericarditis caused by these organisms.