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 machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.006 | 0.006 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
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 source (direct Gemma or distilled Codex), 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".