Myocarditis and Pericarditis as a Complication of Mpox: Case Series and Literature Review
Bibliographic record
Abstract
ABSTRACT: Monkeypox virus is a DNA virus in the orthopoxvirus family, and a multicountry outbreak was declared a Public Health Emergency of International Concern both in 2022 and 2024. Myocarditis is a known complication of many viral infections, and chest pain and electrocardiogram changes may occur from 1 to 4 weeks post-infection. We present 2 clinical cases of mpox-related myocarditis from Canada. We identified 19 additional cases of myocarditis and/or pericarditis in the literature, and data were synthesized with our 2 cases. All 20 patients with available data were hospitalized, 6 of whom were admitted to an intensive care unit. Median time of cardiac symptom onset after initial mpox symptom onset was 5 (range, 0-14) days, elevated troponin was present in 19 of 19 cases (range, 165-21,200 ng/L), arrhythmias were described in 1 patient with Mobitz type 1 and 2 atrioventricular blocks, and echocardiograms showed reduced ejection fraction in 4 of 15 patients. There were no deaths reported. Management of mpox involves symptom control and anti-inflammatories. Recent trials have not shown benefit of tecovirimat compared with placebo in shortening time to lesion resolution; however, in this article, we discuss nuances regarding antivirals in the setting of mpox-related myocarditis.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".