[Epstein-Barr virus. An unusual cause of acute myocarditis in children].
Epstein-Barr virus does not belong to the principal causative agents of acute myocarditis, whose diagnosis and pathogenesis are often difficult to determine. Treatment is also controversial regarding the use of anti-inflammatory or immunosuppressive therapy.


METHODS
We describe a 13-month-old girl, admitted for acute heart failure, in whom cardiac catheterization with endomyocardial biopsy revealed an acute myocarditis. Acute viral titers indicated infectious mononucleosis caused by Epstein-Barr virus, and the virus genome was identified with a polymerase chain reaction in the patient's serum. The patient had clinical improvement after corticosteroid administration.


CONCLUSIONS
The different diagnostic tools and the screening examinations to determine the causative agent of myocarditis are discussed. The frequency of Epstein-Barr virus in pathogenesis is also considered. The favorable outcome with immunosuppressive therapy suggests its administration in cases of acute myocarditis.
Fraisse
A
A
Service de cardiologie A, hôpital de la Timone, Marseille, France.
Paut
O
O
Zandotti
C
C
Lagier
P
P
Camboulives
J
J
Pellissier
J F
JF
D000208:Acute Disease; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D003937:Diagnosis, Differential; D005260:Female; D004854:Herpesvirus 4, Human; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007223:Infant; D007244:Infectious Mononucleosis; D009205:Myocarditis / Q000188:drug therapy / Q000821:virology*; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D007166:Immunosuppressive Agents