title: Severe constrictive pericarditis after parvovirus B19 and human herpes virus 6 infection in a 9-year-old girl.
abstract: We report on a 9-year-old girl who developed signs of congestive heart failure with significant ascites due to constrictive pericarditis. Cardiac catheterization was performed to establish the diagnosis and to rule out restrictive cardiomyopathy. Endomyocardial biopsies were positive for activated macrophages and small-vessel disease, but no viral genomes were detected. Open pericardectomy was performed and histopathologic examination of the resected thickened pericardium showed extensive fibrosis and hyaline degeneration. A combined infection with parvovirus B19 (PVB19) and human herpes virus 6 (HHV6; subtype B) was proven within the resected pericardium. We suggest that local HHV6-induced immunosuppression enhanced the PVB19 infection, thus resulting in chronic infection and leading to constrictive pericarditis.
authors.affiliation: Department of Pediatric Cardiology and Intensive Care Medicine, Georg-August-University Hospital Göttingen, University of Göttingen, Robert-Koch-Str 40, 37075, Göttingen, Germany, david.backhoff@med.uni-goettingen.de.
authors.forename: David
authors.initials: D
authors.lastname: Backhoff
authors.forename: Michael
authors.initials: M
authors.lastname: Steinmetz
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Ruschewski
authors.forename: Barbara
authors.initials: B
authors.lastname: Stastny
authors.forename: Reinhard
authors.initials: R
authors.lastname: Kandolf
authors.forename: Ulrich
authors.initials: U
authors.lastname: Krause
mesh_terms: D001706:Biopsy; D006328:Cardiac Catheterization; D002648:Child; D004279:DNA, Viral / Q000032:analysis*; D003937:Diagnosis, Differential; D018619:Echocardiography, Doppler, Pulsed; D004699:Endocardium / Q000473:pathology; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000209:etiology*; D015654:Herpesvirus 6, Human / Q000235:genetics*; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine; D010322:Parvoviridae Infections / Q000150:complications* / Q000175:diagnosis / Q000821:virology; D016732:Parvovirus B19, Human / Q000235:genetics*; D010492:Pericardiectomy; D010494:Pericarditis, Constrictive / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D019349:Roseolovirus Infections / Q000150:complications* / Q000175:diagnosis / Q000821:virology; D012720:Severity of Illness Index
chemical_list: D004279:DNA, Viral