title: Myocarditis in a traveler returning from the Dominican Republic: an unusual presentation of dengue fever.
abstract: Myocarditis is an uncommon manifestation of dengue fever. We describe a case of a 69-year-old Hispanic male who presented to an emergency room in New York City 3 days after returning from a trip to the Dominican Republic complaining of a 1-day history of chest pain and fever. His first electrocardiogram showed a new left bundle branch block, and initial cardiac enzymes included troponin of 5 ng/dL, creatine kinase-MB of 9 ng/mL, and myoglobin of 234 ng/mL. Dengue fever antibodies were found to be elevated: immunoglobulin M (IgM) titer was 2.48 (reference range < 0.9), and immunoglobulin G (IgG) titer was 4.26 (reference range < 0.9). The patient was diagnosed with myocarditis caused by dengue fever. He improved after 1 week with conservative management in a telemetry unit and was discharged home.
authors.affiliation: Division of Infectious Diseases, Maimonides Medical Center, Brooklyn, New York; Department of Medicine, Lutheran Medical Center, Brooklyn, New York dzepif@gmail.com.
authors.forename: Diego
authors.initials: D
authors.lastname: Zea
authors.affiliation: Division of Infectious Diseases, Maimonides Medical Center, Brooklyn, New York; Department of Medicine, Lutheran Medical Center, Brooklyn, New York.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Foley
authors.affiliation: Division of Infectious Diseases, Maimonides Medical Center, Brooklyn, New York; Department of Medicine, Lutheran Medical Center, Brooklyn, New York.
authors.forename: Jeanne
authors.initials: J
authors.lastname: Carey
mesh_terms: D000368:Aged; D000914:Antibodies, Viral / Q000097:blood*; D003402:Creatine Kinase / Q000097:blood; D003715:Dengue / Q000150:complications / Q000276:immunology / Q000473:pathology* / Q000821:virology; D003716:Dengue Virus; D004293:Dominican Republic; D006801:Humans; D008297:Male; D009205:Myocarditis / Q000150:complications / Q000276:immunology / Q000473:pathology* / Q000821:virology; D009211:Myoglobin / Q000097:blood; D014195:Travel; D014336:Troponin / Q000097:blood
chemical_list: D000914:Antibodies, Viral; D009211:Myoglobin; D014336:Troponin; D003402:Creatine Kinase