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

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.

Respiratory syncytial virus-associated mortality in a healthy 3-year-old child: a case report

“…RSV myocarditis is a well-known extrapulmonary manifestation of severe RSV infection [18]. Although RSV has been detected in human myocardial tissue on PCR [19], the occurrence of cardiogenic shock resulting primarily from heart failure has rarely been documented [20, 21]. Myocardial dysfunction seems a more common clinical picture, notably in infants or in children with congenital heart disease [22–25].…”

RSV‐induced LV dysfunction, what can be the underlying cause?

“…A Rapid literature review showed three case reports [10][11][12] in addition to the cross-sectional study by Checchia et al 13…”

“…A Rapid literature review showed three case reports 10–12 in addition to the cross‐sectional study by Checchia et al 13 which was used as a reference by Rossi et al (Summarized in Table 2). The age range of the retrieved cases (7 months to 7 years) exceeded the age range described in Rossi et al series.…”

Respiratory syncytial virus myopericarditis in an immunocompetent adolescent

“…1 There are few RSV-induced myocarditis case reports, especially in immunocompromised children. 2 This report aimed presenting an uncommon case of RSV cardiovascular manifestation in an immunocompetent adolescent outside of the usual risk group for complications. The study and consent waiver were approved by the local Review Board (CAAE: 54477821.9.0000.0071).…”