A misleading CMV myocarditis during the COVID-19 pandemic: case report

Coronavirus disease 2019 (COVID-19) has been reported as the possible cause of acute myocarditis. Myocarditis is an inflammatory heart disease mostly caused by viral infections. Cytomegalovirus (CMV) primary infection is often not suspected as a cause of myocarditis in immune-competent adults. We re...

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Bibliographic Details
Published in:The Pan African medical journal 2020-07, Vol.36 (167), p.167
Main Authors: Oualim, Sara, Elouarradi, Amal, Hafid, Sara, Naitelhou, Abdelhamid, Sabry, Mohamed
Format: Article
Language:English
Subjects:
Case Report
Clinical Laboratory Techniques
Coronavirus Infections - diagnosis
Coronavirus Infections - epidemiology
Cough - etiology
COVID-19
COVID-19 Testing
cytomegalovirus
Cytomegalovirus Infections - diagnosis
Cytomegalovirus Infections - virology
Diagnosis, Differential
Dyspnea - etiology
Fever - etiology
Humans
immunocompetent
Male
Middle Aged
myocarditis
Myocarditis - diagnosis
Myocarditis - diagnostic imaging
Myocarditis - virology
Pandemics
Pneumonia, Viral - diagnosis
Pneumonia, Viral - epidemiology
Tomography, X-Ray Computed
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Summary:Coronavirus disease 2019 (COVID-19) has been reported as the possible cause of acute myocarditis. Myocarditis is an inflammatory heart disease mostly caused by viral infections. Cytomegalovirus (CMV) primary infection is often not suspected as a cause of myocarditis in immune-competent adults. We report the case of a 37-year-old male admitted with fever, cough and dyspnea. Chest CT showed typical ground-glass changes indicative of viral pneumonia. He was tested negative for COVID-19 but had biological markers that made us still suspect it. He had elevated troponin I level (up to 111.5 ng/mL) and diffuse myocardial dyskinesia along with a decreased left ventricular ejection fraction (LVEF). He was diagnosed with CMV myocarditis with cardiac insufficiency and totally recovered without antiviral therapy. During the COVID-19 pandemic patients may develop myocarditis, still every myocarditis is not a COVID infection. Myocarditis linked to CMV infection may be rare, but life-threatening.
ISSN:1937-8688
1937-8688
DOI:10.11604/pamj.2020.36.167.23922