Abstract
Revisiting acute myocarditis in children to save lives
Highlights
The high incidence of pediatric emergencies presenting with respiratory symptoms and the wide variety of childhood illnesses, including gastroenteritis and fevers without an obvious source, might mask a possible diagnosis of acute myocarditis
The literature reports a high prevalence of histologically proven myocarditis on post-mortem examination in pediatric cases of sudden death based on the presence of a lymphocytic infiltrate necrosis of myocytes
The surveyed literature recommends diagnostic confirmation of acute myocarditis by post-mortem examination according to the Dallas criteria, that is, the presence of a predominantly lymphocytic infiltrate and areas of fibrosis or myocyte necrosis, which are pathognomonic of the disease
Summary
The high incidence of pediatric emergencies presenting with respiratory symptoms and the wide variety of childhood illnesses, including gastroenteritis and fevers without an obvious source, might mask a possible diagnosis of acute myocarditis. Since children with this condition may be asymptomatic or exhibit a variety of nonspecific symptoms, the true incidence of the myocarditis in childhood remains unknown. Despite its frequently benign nature and self-limited course, acute myocarditis may cause rapid clinical deterioration and even lead to sudden unexpected death. A case of sudden unexpected death of an 11-year-old child with tonsillitis illustrates acute myocarditis and the difficulty in diagnosing it
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