Active, Fulminant, Lethal Myocarditis Associated with Parvovirus B19 Infection in an Infant

We report a case of fulminant myocarditis in an 11-month-old female infant who had no other clinical signs of parvovirus infection. The patient presented with severe respiratory distress and died in sudden cardiac arrest 3 h after admission. The clinical presentation was similar to that of an asthma...

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Bibliographic Details
Published in:Clinical infectious diseases 2002-11, Vol.35 (9), p.1027-1031
Main Authors: Papadogiannakis, Nikos, Tolfvenstam, Thomas, Fischler, Björn, Norbeck, Oscar, Broliden, Kristina
Format: Article
Language:English
Subjects:
Autopsies
DNA, Viral - analysis
Female
Humans
Infant
Infants
Infections
Major Articles
Medicin och hälsovetenskap
Muscle tissues
Myocarditis
Myocarditis - complications
Myocarditis - mortality
Myocarditis - pathology
Myocarditis - virology
Myocardium
Parvoviridae Infections - complications
Parvoviridae Infections - mortality
Parvoviridae Infections - pathology
Parvoviridae Infections - virology
Parvovirus
Parvovirus B19, Human - genetics
Parvovirus B19, Human - isolation & purification
Polymerase Chain Reaction
T lymphocytes
Viruses
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Summary:We report a case of fulminant myocarditis in an 11-month-old female infant who had no other clinical signs of parvovirus infection. The patient presented with severe respiratory distress and died in sudden cardiac arrest 3 h after admission. The clinical presentation was similar to that of an asthmatic attack. Autopsy revealed signs of acute lymphocytic myocarditis. Parvovirus DNA was demonstrated by polymerase chain reaction (PCR) analysis of tissue sections obtained from the heart, lungs, liver, kidneys, and spleen. Transmission electron microscopy of myocardial tissue showed crystalline arrays with the appearance of parvovirus. The results of immunohistochemical analysis for the detection of parvovirus antigens were negative, and no viral inclusions were demonstrable. We suggest that the current diagnostic procedure underestimates the prevalence of parvovirus-associated myocarditis. PCR analysis should be used as a complement in suspected cases, to enhance the rate of detection of the infection and to reach a correct diagnosis.
ISSN:1058-4838
1537-6591
1537-6591
DOI:10.1086/342574