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Pediatr Crit Care Med. 2001 Jul;2(3):271-273. doi: 10.1097/00130478-200107000-00015.

Cytomegalovirus myocarditis in a healthy infant: Complete recovery after ganciclovir treatment.

Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies

Natalie Dehtiar, Matityahu Eherlichman, Elie Picard, David Kleid, Joram Glaser, David Raveh, Yechiel Schlesinger

Affiliations

  1. Department of Pediatrics (Drs. Dehtiar and Eherlichman), the Pediatric Intensive Care Unit (Drs. Picard and Kleid), the Department of Pediatric Cardiology (Dr. Glaser), and the Infectious Diseases Unit (Drs. Raveh and Schlesinger), Shaare Zedek Medical Center, Jerusalem, Israel.

PMID: 12793954 DOI: 10.1097/00130478-200107000-00015

Abstract

OBJECTIVES: To report a case of acute myocarditis caused by cytomegalovirus infection in a 15-month-old immunocompetent infant completely recovered with ganciclovir treatment. DESIGN: Descriptive case report. SETTING: Pediatric intensive care unit in a general hospital. Patient: A 15-month-old healthy girl with acute, severe myocarditis. INTERVENTION: General supportive intensive care and mechanical ventilatory support, iv immunoglobulin, and iv ganciclovir. MEASUREMENTS AND MAIN RESULTS: Intensive supportive care including iv fluids, mechanical ventilatory support, diuretics (furosemide, spironolactone), digoxin, dobutamine, captopril, methylprednisolone, and iv immunoglobulin. Despite clinical stabilization, shortening fraction remained very poor at 17%. Addition of iv ganciclovir resulted in prompt and complete recovery of the cardiac muscle contractility with a shortening fraction of 35% that remained normal during a long follow-up period. CONCLUSIONS: Cytomegalovirus should be considered as a causative agent in acute myocarditis even in the normal, immunocompetent host. In such cases, addition of ganciclovir treatment should be strongly considered.

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