Neonatal myocarditis due to Coxsackie: case report and literature review

Authors

DOI:

https://doi.org/10.5281/zenodo.10998879

Keywords:

Early Diagnosis, Prognosis, Coxsackievirus Infections, Newborn, Myocarditis

Abstract

This article aims to elucidate viral myocarditis in neonates, focusing on a case involving Coxsackie virus, in order to enhance early detection and treatment, and, therefore, mitigating the substantial morbidity and mortality associated with this condition. Our study details the clinical course of a female newborn with Coxsackievirus-induced myocarditis, who underwent diagnostic modalities such as echocardiogram, cardiac magnetic resonance, and serial biomarker analysis, all of which allowed us to outline the disease's natural progression and its response to intervention over time. Based on a literature review we identified 6 similar cases, spanning from 1962 to 2022. In this analysis we assessed clinical presentation, diagnostic methodologies, treatment strategies, and prognostic outcomes, drawing comparisons between our case and reported instances. The objective is to highlight optimal clinical practices for managing this pathology effectively. Furthermore, we approach the pivotal role of early diagnosis and its impact on disease prognosis. We emphasize that, though rare, viral myocarditis in neonates can lead to a high rate of mortality, which is why a prompt diagnosis and an appropriate intervention are imperative to improve the outcome.

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Author Biography

  • Dagoberto Delgado-Franco, <p>Centro M&eacute;dico ABC, Departamento de Neonatolog&iacute;a. Ciudad de M&eacute;xico, M&eacute;xico.</p>

    El Doctor es médico pediatra, especialista en neonatología y posgraduado en terapia intensiva neonatal, además de Maestro en Ciencias Clínicas.

    Se ha desempeñado como clínico en la Unidad de Cuidados Intensivos Neonatales del Hospital Civil de Guadalajara Dr. Juan I Menchaca y la unidad de cuidados intensivos del Instituto Nacional de Perinatología. Su trayectoria académica incluye actividades docentes en la Universidad de Guadalajara como profesor de cátedra y la Universidad Nacional Autónoma de México como Profesor Adjunto de la Especialidad de Neonatología del Instituto Nacional de Perinatología y Profesor Adjunto del Posgrado de Terapia Intensiva Neonatal del Instituto Nacional de Neonatología. Participo como Secretario del Comité de Ética en Investigación del Instituto Nacional de Perinatología, además de actividades de investigación y publicaciones internacionales.

    Actualmente es Jefe de Neonatología del Centro Medico ABC y Profesor Universitario en la Escuela Nacional de Medicina del Tecnológico de Monterrey, Campus Ciudad de México.

References

Noites I, Soares P Miranda JO, et al. Neonatal cardiomyopathy: a 20-year overview of a reference centre. Journal of Pediatric and Neonatal Individualized Medicine. 2020;9(1):e090129. doi: 10.7363/090129.

Lipshultz SE, Law YM, Asante-Korang A, et al. Cardiomyopathy in Children: Classification and Diagnosis: A Scientific Statement From the American Heart Association. Circulation. 2019;140(1):e9-e68. doi: 10.1161/CIR.0000000000000682.

Law YM, Lal AK, Chen S, et al.; American Heart Association Pediatric Heart Failure and Transplantation Committee of the Council on Lifelong Congenital Heart Disease and Heart Health in the Young and Stroke Council. Diagnosis and Management of Myocarditis in Children: A Scientific Statement From the American Heart Association. Circulation. 2021;144(6):e123-35. doi: 10.1161/CIR.0000000000001001.

Ng KF, Gibb J, Struik S, et al.; Neonatal Enteroviral Myocarditis Consortium. Remember the heart: neonatal myocarditis. Arch Dis Child. 2023;108(5):417-9. doi: 10.1136/archdischild-2023-325316.

Bejiqi R, Retkoceri R, Maloku A, et al. The Diagnostic and Clinical Approach to Pediatric Myocarditis: A Review of the Current Literature. Open Access Maced J Med Sci. 2019;7(1):162-73. doi: 10.3889/oamjms.2019.010.

Jennings RC. Coxsackie group B fatal neonatal myocarditis associated with cardiomegaly. J Clin Pathol. 1966;19(4):325-7. doi: 10.1136/jcp.19.4.325.

Storm KK, De Herdt D, Couderé K, et al.; VIRO-TypeNed. Severe neonatal enterovirus infection in twins with different outcomes: A case report. Front Pediatr. 2023 Sep;11:1181698. doi: 10.3389/fped.2023.1181698.

Tseng JJ, Lin CH, Lin MC. Long-Term Outcomes of Pediatric Enterovirus Infection in Taiwan: A Population-Based Cohort Study. Front Pediatr. 2020;8:285. doi: 10.3389/fped.2020.00285.

Bansal M. Myocardial disorders in the neonate. NeoReviews. 2018;19(7):e403-9. doi: 10.1542/neo.19-7-e403.

Chuang YY, Huang YC. Enteroviral infection in neonates. J Microbiol Immunol Infect. 2019;52(6):851-7. doi: 10.1016/j.jmii.2019.08.018.

Annoni G, De Rienzo F, Nonini S, et al. Enterovirus fulminant myocarditis as cause of acute heart failure in a newborn. Int J Cardiol Heart Vasc. 2022;42:101093. doi: 10.1016/j.ijcha.2022.101093.

Sandoni M, Ciardo L, Tamburini C, et al. Enteroviral Infections in the First Three Months of Life. Pathogens. 2022;11(1):60. doi: 10.3390/pathogens11010060.

Schwartz BH, Stein NR, Eshaghian S, et al. Recurrent Myocarditis Treated with Intravenous Immune Globulin and Steroids. Am J Case Rep. 2022;23:e935974. doi: 10.12659/AJCR.935974.

Yen CY, Hung MC, Wong YC, et al. Role of intravenous immunoglobulin therapy in the survival rate of pediatric patients with acute myocarditis: A systematic review and meta-analysis. Sci Rep. 2019;9(1):10459. doi: 10.1038/s41598-019-46888-0.

Zhang M, Wang H, Tang J, et al. Clinical characteristics of severe neonatal enterovirus infection: a systematic review. BMC Pediatr. 2021;21(1):127. doi: 10.1186/s12887-021-02599-y.

Putschoegl A, Auerbach S. Diagnosis, evaluation, and treatment of myocarditis in children. Pediatric Clinics. 2020;67(5):855-74. doi: 10.1016/j.pcl.2020.06.013.

Singanayagam A, Moore C, Froude S, et al. Increased reports of severe myocarditis associated with enterovirus infection in neonates, United Kingdom, 27 June 2022 to 26 April 2023. Euro Surveill. 2023;28(39):2300313. doi: 10.2807/1560-7917.ES.2023.28.39.2300313.

Ning J. Disease Not To Be Ignored: The Second Viremia of Coxsackie. The Pediatric Infectious Disease Journal. 2023;42(4):e134-5. doi: 10.1097/INF.0000000000003821.

Singh S, Mane SS, Kasniya G, et al. Enteroviral Infections in Infants. Newborn (Clarksville). 2022;1(3):297-305. doi: 10.5005/jp-journals-11002-0036.

Chang YJ, Hsiao HJ, Hsia SH, et al. Analysis of clinical parameters and echocardiography as predictors of fatal pediatric myocarditis. PLoS One. 2019;14(3):e0214087. doi: 10.1371/journal.pone.0214087.

Zanatta A, Carturan E, Rizzo S, et al. Story telling of myocarditis. Int J Cardiol. 2019;294:61-64. doi: 10.1016/j.ijcard.2019.07.046.

Robino G, Perlman A, Togo Y, et al. Fatal neonatal infection due to Coxsackie B2 virus. Report of generalized infection and myocarditis in the newborn. J Pediatr. 1962;61:911-8. doi: 10.1016/s0022-3476(62)80205-4.

Lu JC, Koay KW, Ramers CB, et al. Neonate with coxsackie B1 infection, cardiomyopathy and arrhythmias. J Natl Med Assoc. 2005;97(7):1028-30.

De Vetten L, Bergman KA, Elzenga NJ, et al. Neonatal myocardial infarction or myocarditis? Pediatr Cardiol. 2011;32(4):492-7. doi: 10.1007/s00246-010-9865-8.

Tanabe T, Osaki M, Sato K, et al. Neonatal myocarditis that needed to be differentiated from myocardial ischemia. Pediatr Int. 2022;64(1):e14739. doi: 10.1111/ped.14739.

Savorgnan F, Checchia PA. Medical Management of Acute Fulminant Myocarditis. Pediatric Critical Care: Current Controversies. 2019:85-96. doi: 10.1007/978-3-319-96499-7_5.

Inwald D, Franklin O, Cubitt D, et al. Enterovirus myocarditis as a cause of neonatal collapse. Arch Dis Child Fetal Neonatal Ed. 2004;89(5):F461-2. doi: 10.1136/adc.2003.034439.

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Published

2024-05-03

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Review Article