Kao Kai-Liang, Yeh Shu-Jen, Chen Chia-Chun
Department of Pediatrics, Far Eastern Memorial Hospital, Pan-Chiao, Taipei County 220, Taiwan, ROC.
Pediatr Cardiol. 2010 Jul;31(5):703-6. doi: 10.1007/s00246-009-9637-5. Epub 2010 Jan 20.
Acute myopericarditis is a major cause of acquired heart disease worldwide in pediatric patients. Various viruses have been reported as the etiology, of which varicella zoster virus was first reported in 1953. However, since nationwide administration of the varicella vaccine, reports of varicella-associated myopericaridits have become sporadic. We report a case of varicella myopericarditis with an initial manifestation of chest pain, tachycardia, and hypotension. Typical skin vesicles developed 2 days after these symptoms, which confirmed the diagnosis. Intravenous immunoglobulin was administered before the appearance of the skin vesicles under the impression of suspected Coxsackie virus infection. Intravenous acyclovir effectively controlled the progression of the disease, and both clinical symptoms and electrocardiographic changes subsided soon after the use of an antiviral agent. Varicella zoster virus serum IgM antibody also showed positive test results. On the following visit, the patient's myocardial function had fully recovered from this episode.
急性心肌心包炎是全球范围内小儿患者后天性心脏病的主要病因。已有多种病毒被报道为其病因，其中水痘带状疱疹病毒于1953年首次被报道。然而，自从水痘疫苗在全国范围内接种以来，水痘相关性心肌心包炎的报道已变得零星。我们报告一例以胸痛、心动过速和低血压为初始表现的水痘性心肌心包炎病例。在这些症状出现2天后出现典型的皮肤水疱，这证实了诊断。在疑似柯萨奇病毒感染的情况下，在皮肤水疱出现前给予静脉注射免疫球蛋白。静脉注射阿昔洛韦有效控制了疾病进展，使用抗病毒药物后临床症状和心电图改变很快消退。水痘带状疱疹病毒血清IgM抗体检测结果也呈阳性。在随后的随访中，患者的心肌功能已从此次发作中完全恢复。
