Acute chest pain in an adolescent with cystic fibrosis in September: Would you have thought about this?

Abstract

Acute chest pain is common in patients with cystic fibrosis (CF). Here we report the case of an adolescent who suffered acute chest pain in September after an history of acute abdominal pain and fever. The reason for this clinical sceneriao was found to be Coxsackievirus B3, known to be responsible of Bornholm disease, a frequent but under recognized viral myositis. The diagnosis is mainly clinical, but evocating this diagnosis may avoid unnecessary exam.

Coxsackievirus B infections are common in Cystic Fibrosis and experimental evidence supports protection by vaccination

“…Numerous studies have demonstrated that respiratory viruses, including enteroviruses, influence pulmonary exacerbations in CF ( Asner et al., 2012 ; de Almeida et al., 2010 ; Goffard et al., 2014 ; Johansen and Hoiby, 1992 ; Petersen et al., 1981 ; Singanayagam et al., 2012 ; Wat et al., 2008 ). Enteroviruses have been found in pharyngeal samples of individuals with CF experiencing pulmonary exacerbations ( de Almeida et al., 2010 ; Dijkema et al., 2016 ; Dowaikh et al., 2017 ; Goffard et al., 2014 ; Hamed et al., 2022 ; Ong et al., 1989 ; van Ewijk et al., 2008 ). Moreover, a recent cross-sectional observational study showed a significant relationship between sputum-positive bacterial culture and enterovirus positivity.…”

“…They primarily infect mucosal tissue in the respiratory and intestinal tracts and include rhinoviruses, echoviruses, polioviruses, and Coxsackie A and B viruses. These have all (with the exception of polioviruses) been detected in nasopharyngeal samples from patients with CF, especially those experiencing pulmonary exacerbations ( de Almeida et al., 2010 ; Dijkema et al., 2016 ; Dowaikh et al., 2017 ; Goffard et al., 2014 ; Hamed et al., 2022 ; Ong et al., 1989 ; van Ewijk et al., 2008 ). Enterovirus vaccines could therefore help to reduce respiratory virus infections in CF.…”

“…Infections are common and mainly occur in childhood, but can also happen in adulthood. CVB infections have been reported in CF ( Dowaikh et al., 2017 ; Ong et al., 1989 ). Moreover, we have found that F508del mice (a murine model of CF) infected with CVB serotype B3 (CVB3) have increased morbidity and mortality compared with wild-type animals.…”