Viral Myocarditis in the Setting of Delayed Manifestation of Hamman-Rich Syndrome

Abstract

Acute respiratory distress syndrome (ARDS)-like symptoms and rapid progression characterize the interstitial lung disease known as acute interstitial pneumonitis, also known as Hamman-Rich syndrome. It has a bad prognosis and a high incidence of mortality. We describe the case of a 25-year-old male patient with acute-onset type I respiratory failure with detrimental X-ray abnormalities who presented to the emergency room without any history of pulmonary disease or smoking. The provisional diagnosis of Hamman-Rich syndrome was reached after other clinical entities were ruled out based on CT findings. Myocardial hypokinesis of the apex and septum, as well as a modest systolic dysfunction (ejection fraction: 50%) similar to acute myocarditis, were detected by echocardiogram. Acute myocarditis in the setting of Hamman-Rich syndrome has been anecdotally reported and its mechanism remains to be elucidated.

Chemical Pneumonitis and Reactive Airways Dysfunction Syndrome After Fumigation Exposure to Dimethanol and Glutaraldehyde: A Silent Menace Unmasked

“…There are case reports of diffused alveolar damage due to drugs like acenocoumarol [7]. Interstitial pneumonitis sometimes may be confused with chemical pneumonitis which can happen after viral fever [8].…”

“…There are case reports of diffused alveolar damage due to drugs like acenocoumarol [ 7 ]. Interstitial pneumonitis sometimes may be confused with chemical pneumonitis which can happen after viral fever [ 8 ]. Employers and workers should be aware of the hazards of dimethanol and glutaraldehyde and follow regulatory requirements and guidelines.…”