Sex: M
Vaccine: COVID19
Symptoms: Adenovirus test, Blood creatine phosphokinase MB, Blood culture, Body mass index, Body temperature
Clinical narrative: perimyocarditis/3 days of sharp, intermittent, retrosternal pain, with associated fever (38 degree C), headache, loose bowel movement, and cough; This is a literature report. This author reported similar events for eight patients. This is the sixth of eight reports.  A 15-year-old (also reported as 15.8-year-old) male with obesity, insulin resistance, and dyslipidemia presented to outside hospital ED with 3 days of sharp, intermittent, retrosternal pain, with associated fever (38 degree C), headache, loose bowel movement, and cough. Patient denied any trauma or recent viral illnesses. No prior history of SARS-CoV-2 infection. He had received the second dose of the BNT162b2 vaccine 2 days prior to symptom onset. On physical examination, there was diffuse reproducible chest wall tenderness. Laboratories unremarkable aside from elevated peak troponin-I of 5.1 ng/mL and Creatine Kinase Myocardial Band of 19.9 ng/mL. ECG demonstrated normal sinus rhythm, with no significant ST-segment changes. Chest X-ray was normal. TTE showed no structural abnormalities and qualitatively normal LVSF. He recovered with no medical intervention. Infectious workup was negative but limited to RPP, adenovirus plasma PCR, enterovirus plasma PCR, SARS-CoV-2 nucleocapsid IgG, blood culture, and gastrointestinal panel.   Demographic and clinical characteristics: Body mass index (kg/m2) 29.5. Past medical history (PMH) Insulin resistance dyslipidemia. History of prior COVID-19 infection No. BNT162b2 vaccine dose #2. Days between vaccine and symptom onset 2. Length of stay (hours) 37. Laboratories: White blood cell count (Ref: 5-10) 5.9; Peak troponin-I (Ref: 0.00-0.08 ng/mL) 5.10; Discharge troponin-I (Ref: 0.00-0.08 ng/mL) 1.30; CKMB (Ref:0-3.5ng/mL) 19.9; D-dimer (Ref: 0.27-0.41 mmg/mL) 0.53. COVID-19 testing: SARS-CoV-2 PCR Negative; SARS-CoV-2 nucleocapsid IgG Negative EKG findings Normal sinus rhythm. Imaging Chest radiograph (cardiopulmonary findings) Negative; Left ventricular ejection fraction on ECHO 62; Pericardial effusion present No; Cardiac MRI performed No.  DISCUSSION Herein described is the first case series from a single institution of 8 adolescent males with a diagnosis of perimyocarditis in the setting of recent BNT162b2 vaccination with no other identifiable cause.  No follow-up attempts are needed, information about batch number cannot be obtained.; Sender's Comments: A contributory role of BNT162B2 to the event perimyocarditis cannot be excluded based on the plausible temporal relationship, product safety profile and lack of reported alternative explanation at this time. This case will be reassessed if additional information becomes available.  The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.,Linked Report(s) : PFIZER INC-202101133568 Same article/drug/event; different patient