CC BY-NC-ND 4.0 · AJP Rep 2017; 07(02): e124-e126
DOI: 10.1055/s-0037-1601352
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA

Peculiar Clinical Presentation of Coxsackievirus B4 Infection: Neonatal Restrictive Cardiomyopathy

Pauline Le Van Quyen
1  Departement de Pathologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
,
Philippe Desprez
2  Service de Pédiatrie, Centre Hospitalier Universitaire Pointe-à-Pitre/Abymes, Pointe-à-Pitre, France
,
Angelo Livolsi
3  Unité de Cardiopédiatrie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
,
Véronique Lindner
1  Departement de Pathologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
,
Samira Fafi-Kremer
4  Service de Virologie, Plateau Technique de Microbiologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
5  Faculté de Médecine, Université de Strasbourg, Strasbourg, France
,
Pauline Helms
3  Unité de Cardiopédiatrie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
,
Maria Cristina Antal
1  Departement de Pathologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
5  Faculté de Médecine, Université de Strasbourg, Strasbourg, France
› Author Affiliations
Further Information

Publication History

25 November 2016

09 February 2017

Publication Date:
29 June 2017 (online)

  

Abstract

Introduction Restrictive cardiomyopathy in fetuses and neonates is extremely rare and has a poor outcome. Its etiology in neonates is elusive: metabolic diseases (e.g., Gaucher, Hurler syndrome), neuromuscular disorders (e.g., muscular dystrophies, myofibrillar myopathies), or rare presentation of genetic syndromes (e.g., Coffin–Lowry syndrome) account for a minority of the cases, the majority remaining idiopathic.

Case Study We report the case of a 17-day-old male infant presenting cardiogenic shock following a restrictive dysfunction of the left ventricle. Postmortem investigations revealed coxsackievirus B4 myocarditis with histological lesions limited to the left heart. However, polymerase chain reaction (PCR) for coxsackievirus B4 was positive in the left as well as in the right ventricular samples.

Conclusion In conclusion, coxsackievirus myocarditis is a cause of restrictive cardiomyopathy, and its diagnosis should involve PCR screening as a more sensitive technique.