A case presentation of a fatal dengue myocarditis showing evidence for dengue virus-induced lesion

Dengue is a prevalent arthropod-borne viral disease in tropical and subtropical areas of the globe. Dengue clinical manifestations include asymptomatic infections; undifferentiated fever; dengue fever, which is characterized by fever, headache, retroorbital pain, myalgia, and arthralgia; and a sever...

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Bibliographic Details
Published in:European heart journal. Acute cardiovascular care 2013-06, Vol.2 (2), p.127-130
Main Authors: Miranda, Carlos Henrique, Borges, Marcos de Carvalho, Schmidt, André, Pazin-Filho, Antônio, Rossi, Marcos Antônio, Ramos, Simone Gusmão, Lopes da Fonseca, Benedito Antônio
Format: Article
Language:English
Subjects:
Acute Heart Failure
Adult
Fatal Outcome
Female
Humans
Myocarditis - virology
Severe Dengue
Shock, Cardiogenic - virology
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Summary:Dengue is a prevalent arthropod-borne viral disease in tropical and subtropical areas of the globe. Dengue clinical manifestations include asymptomatic infections; undifferentiated fever; dengue fever, which is characterized by fever, headache, retroorbital pain, myalgia, and arthralgia; and a severe form of the disease denominated dengue haemorrhagic fever/dengue shock syndrome, characterized by haemoconcentration, thrombocytopenia, and bleeding tendency. However, atypical manifestations, such as liver, central nervous system, and cardiac involvement, have been increasingly reported. We report an atypical and rare presentation of dengue disease marked by a dramatic and fatal cardiogenic shock due to acute myocarditis. Histopathological analysis of heart tissue showed several multifocal areas of muscle necrosis and intense interstitial oedema associated with clusters of virus particles inside the cardiomyocytes and in the interstitial space, providing evidence of a possible direct action of dengue virus on myocardium.
ISSN:2048-8726
2048-8734
DOI:10.1177/2048872613475889