Fatal myocarditis associated with ECHO virus, type 22, infection in a child with apparent immunological deficiency

Abstract

A 14-month-old boy succumbed to fulminating myocarditis. ECHO virus, type 22, was recovered in high titer from the myocardium, and in lower titer from pericardial fluid, liver, and lung. The diagnosis of congenital agammaglobulinemia was supported at autopsy by the absence of plasma cells, abnormal organization of lymphoid tissue, and absence of immunoglobulins in all tissues examined by fluorescent antibody techniques. This is believed to be the first isolation of an ECHO virus from the heart. Fatal virus infection in a child with non-lymphopenic agammaglobulinemia, with the exception of hepatitis, appears to be a very rare event.