Acute heart failure due to dilated cardiomyopathy exacerbated by systemic parechovirus A1 infection in an infant. (March 2021)

• Record Type: Journal Article
• Authors: Maki, Shun; Aizawa, Yuta; Ito, Yuki; Suda, Masashi; Saitoh, Akihiko
• Is Part Of: International journal of infectious diseases. Volume 104(2021)
• Page Start: 273
• Page End: 275
• Publication Date: 2021-03
• Subjects: Parechovirus A1 -- Myocardial diseases -- Dilated cardiomyopathy -- Infant; Communicable diseases -- Periodicals; Communicable Diseases -- Periodicals; Communicable diseases; Periodicals; Electronic journals; 616.9
• DOI: 10.1016/j.ijid.2021.01.021
• Languages: English
• ISSNs: 1201-9712

Abstract

Highlights: An infant with acute heart failure due to dilated cardiomyopathy was hospitalized. Parechovirus A1 (PeV-A1) was detected in blood, stool, and throat swab samples from the patient. PeV-A1 infection could trigger exacerbation of myocardial diseases in children. PeV-A1 infection needs to be included as a cause of worsening myocardial diseases in children. Abstract: Parechovirus A1 (PeV-A1) often causes mild respiratory or gastrointestinal disease. Herein we report a case of acute heart failure due to dilated cardiomyopathy exacerbated by acute PeV-A1 infection in a 10-month-old infant. He was brought to our hospital with acute respiratory distress and compensated shock. Echocardiogram showed a dilated left ventricle and severe mitral regurgitation, consistent with dilated cardiomyopathy. PeV-A1 infection was confirmed by (1) positive PCR test results for PeV-A in multiple anatomical sites, including blood, stool, and throat, (2) the genetic sequence of viral protein, and (3) an increase in paired serum PeV-A1-specific neutralizing antibody titers. A few, scattered case reports in infants and young children also indicate the association between myocarditis and/or dilated cardiomyopathy and PeV-A1 infection. In conclusion, PeV-A1 infection could be associated with exacerbation of myocardial diseases in infants and young children; thus PeV-A1 needs to be evaluated as a viral cause of such a condition.