Active, fulminant, lethal myocarditis associated with parvovirus B19 infection in an infant

Clin Infect Dis. 2002 Nov 1;35(9):1027-31. doi: 10.1086/342574. Epub 2002 Oct 11.

Abstract

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.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • DNA, Viral / analysis
  • Female
  • Humans
  • Infant
  • Myocarditis / complications
  • Myocarditis / mortality
  • Myocarditis / pathology
  • Myocarditis / virology*
  • Parvoviridae Infections / complications*
  • Parvoviridae Infections / mortality
  • Parvoviridae Infections / pathology
  • Parvoviridae Infections / virology
  • Parvovirus B19, Human* / genetics
  • Parvovirus B19, Human* / isolation & purification
  • Polymerase Chain Reaction

Substances

  • DNA, Viral