title: First therapeutic use of Artesunate in treatment of human herpesvirus 6B myocarditis in a child.
abstract: BACKGROUND
  Human herpesvirus 6 (HHV-6) is an important cause of fulminant or acute viral myocarditis. However, insufficiency of standard antiviral treatment against HHV-6 is an emerging problem.
  
  
  OBJECTIVE
  To describe the case of child with HHV-6 myocarditis who was treated by unloading with a left ventricular assist device and Artesunate.
  
  
  METHODS
  Case report supported by histological and viral diagnoses via a combination of histology/immunohistochemistry and polymerase chain reaction techniques performed on cardiac tissues before and after treatment.
  
  
  RESULTS
  Following therapeutic intervention, the clinical status and heart function improved. Endomyocardial biopsies revealed decreased levels of HHV-6B DNA in the myocardium and the disappearance of histological findings in support of lymphocytic myocarditis. Left ventricular assist device could be explanted. No adverse effects of Artesunate were noted.
  
  
  CONCLUSIONS
  In addition to existing heart failure treatments, Artesunate can be considered as an effective candidate for clinical use in cases of HHV-6B associated myocarditis.
authors.affiliation: Department of Pediatric Cardiology, Children's Heart Centre, Skåne University Hospital, Lund, Sweden. nina.hakacova@gmail.com
authors.forename: Nina
authors.initials: N
authors.lastname: Hakacova
authors.forename: Karin
authors.initials: K
authors.lastname: Klingel
authors.forename: Reinhard
authors.initials: R
authors.lastname: Kandolf
authors.forename: Elin
authors.initials: E
authors.lastname: Engdahl
authors.forename: Anna
authors.initials: A
authors.lastname: Fogdell-Hahn
authors.forename: Thomas
authors.initials: T
authors.lastname: Higgins
mesh_terms: D000998:Antiviral Agents / Q000494:pharmacology / Q000627:therapeutic use*; D037621:Artemisinins / Q000494:pharmacology / Q000627:therapeutic use*; D000077332:Artesunate; D006353:Heart-Assist Devices; D015654:Herpesvirus 6, Human / Q000187:drug effects* / Q000235:genetics; D006801:Humans; D007223:Infant; D009205:Myocarditis / Q000188:drug therapy* / Q000821:virology; D016133:Polymerase Chain Reaction; D019349:Roseolovirus Infections / Q000188:drug therapy* / Q000821:virology; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000473:pathology / Q000628:therapy
chemical_list: D000998:Antiviral Agents; D037621:Artemisinins; D000077332:Artesunate