Severe eosinophilic myocarditis associated with modafinil in a patient with normal peripheral eosinophil count
Eosinophilic myocarditis (EM) is a rare form of myocardial inflammation characterized by myocardial eosinophilic infiltration . It can lead to a broad spectrum of clinical symptoms, ranging from asymptomatic cases to dramatic and life-threatening progression with rapid myocardial damage and acute heart failure [1, 2, 3, 4]. The etiology is heterogeneous and hypersensitivity or allergic reactions as well as hematological diseases or neoplastic disorders can lead to EM . Eosinophilia in peripheral blood is present in the majority of patients and often suggestive for the diagnosis [1, 5]. EM in the absence of hypereosinophilia, however, is a diagnostic challenge and can lead to a potentially fatal delay in suitable treatment . We present the second description of modafinil-associated acute necrotizing myocarditis after a fatal case, which was published in 2006 . In our case, timely diagnosis by histology and administration of corticosteroid therapy enabled full recovery.
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Conflict of interest
All authors agreed to submit this case report and declared no conflict of interests.
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