Successful Treatment of Acute Enteric Myocarditis with IVIG Infusion: An Unusual Complication of Enteric Fever.

Abstract

Myocarditis, the inflammation of myocardium can be caused by a variety of etiological agents with clinical manifestations ranging from asymptomatic to cardiogenic shock. Enteric fever is a very common illness in children and can have a wide range of complications both enteric and non-enteric. The reported incidence of myocarditis in enteric fever ranges from about 1-5%. Paediatricians must be aware of the rare complications that might make the diagnosis challenging. We present one such case of a 6-year-old boy who came to us with a history of fever, diarrhoea and hypotension. On initial evaluation, the child was in cardiogenic shock and was started on IV antibiotics and inotropes. Laboratory evaluation confirmed enteric fever, and Electrocardiogram and echocardiography revealed myocarditis with dilated cardiomyopathy. The child did not improve with initial supportive care. Administration of IVIG resulted in a dramatic improvement in LVEF. The child is now thriving well with normal cardiac function.