Case report of severe myocarditis in an immunocompromised child with Respiratory Syncytial Virus infection

Hiroki Miura,Tetsushi Yoshikawa,Kazuko Kudo,Masatoki Sato,Tadayoshi Hata,Fumihiko Hattori,Hidetoshi Uchida

doi:10.1186/s12887-018-1027-9

Hiroki Miura, Tetsushi Yoshikawa + Show 5 more

Open Access

https://doi.org/10.1186/s12887-018-1027-9

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Abstract

BackgroundRespiratory syncytial virus (RSV) infection is common and may be severe among patients with preexisting cardiac anomalies, but direct involvement of myocardial damage is not common in those patients. Additionally, myocardial involvement has been rarely described among immune compromised children.Case presentationA 4-year-old girl with acute lymphoblastic leukemia who received maintenance chemotherapy in an outpatient clinic developed systemic inflammatory response syndrome. RSV infection was confirmed by a positive rapid antigen test and serological assay. Subsequently, she was diagnosed with severe myocarditis caused by RSV infection, which was diagnosed by abnormal findings of cardiac echography and ECG and elevated biomarkers for myocardial damage. Then, she was treated in the intensive care unit for 13 days. High amounts of RSV type B RNA was detected in tracheal aspirates and serum sample.ConclusionThis case report emphasizes that RSV infection may be associated with myocarditis in immunocompromised children receiving maintenance chemotherapy.

Highlights

Respiratory syncytial virus (RSV) infection is common and may be severe among patients with preexisting cardiac anomalies, but direct involvement of myocardial damage is not common in those patients
This case report emphasizes that RSV infection may be associated with myocarditis in immunocompromised children receiving maintenance chemotherapy
Severe lower respiratory tract infection (LRTI) caused by RSV infection is associated with high morbidity in patients with acute lymphoblastic leukemia [1], no RSV myocarditis case has been reported in such patients

Summary

Introduction

Respiratory syncytial virus (RSV) infection is common and may be severe among patients with preexisting cardiac anomalies, but direct involvement of myocardial damage is not common in those patients. Conclusion: This case report emphasizes that RSV infection may be associated with myocarditis in immunocompromised children receiving maintenance chemotherapy. It is well known that premature infants, infants with cardiac diseases, and immunocompromised patients, including leukemic children, are at high risk for more severe and complicated RSV infection.

Results

Conclusion