Acute Nonrheumatic Streptococcus pyogenes Myopericarditis Mimicking Viral Myocarditis in a 43-Year-Old Man: A Case Report

A 43-year-old healthy man presented with acute left-sided chest pressure after 2 days of exudative pharyngitis. Electrocardiography results showed diffuse ST-segment elevation and PR depression, and high-sensitivity troponin levels increased from 384 ng/L to 3297 ng/L. The findings of coronary angiography, performed urgently, were unrevealing. A rapid streptococcal antigen test was negative; however, pharyngeal culture grew Streptococcus pyogenes. The administration of amoxicillin, colchicine, and indomethacin led to clinical recovery. This case highlights nonrheumatic S pyogenes myopericarditis as a mimic of viral myocarditis and underscores the importance of initiating empirical antibiotics in this clinical setting while awaiting culture results.