Varicella myocarditis in an adult.
A 24 year old male with varicella myocarditis was admitted with chest pain and fever up to 39 degrees C. The ECG showed J point and ST elevation in leads V2-V4, and inverted T waves in leads V5 and V6. Creatine kinase (CK) was raised to 435 U/l (CK-MB 36 U/l), troponin I was 63.4 microgram/l, and lactate dehydrogenase was 359 U/l, suggesting cardiac involvement of varicella infection. The left ventricle was dilated (58 mm) and left ventricular ejection fraction was globally reduced (ejection fraction 45%). Myocarditis was confirmed by endomyocardial biopsy. The patient was treated with specific varicella hyperimmunoglobulins, aciclovir, and a non-steroidal anti-inflammatory drug. During two months follow up the patient recovered completely. This case report is a reminder that a varicella infection can cause myocarditis in adults. Early diagnosis and appropriate treatment of this rare form of myocarditis may lead to complete recovery.
Alter
P
P
Department of Internal Medicine-Cardiology, Philipps-University of Marburg, Baldingerstrabetae, D-35033 Marburg/Lahn, Germany. alter@mailer.uni-marburg.de
Grimm
W
W
Maisch
B
B
D000328:Adult; D002644:Chickenpox / Q000175:diagnosis*; D014645:Herpesvirus 3, Human / Q000302:isolation & purification; D006801:Humans; D008297:Male; D009205:Myocarditis / Q000175:diagnosis*