一名免疫功能低下儿童感染呼吸道合胞病毒后发生重症心肌炎的病例报告。
Case report of severe myocarditis in an immunocompromised child with Respiratory Syncytial Virus infection.
作者信息
Miura Hiroki, Hattori Fumihiko, Uchida Hidetoshi, Hata Tadayoshi, Kudo Kazuko, Sato Masatoki, Yoshikawa Tetsushi
机构信息
Department of Pediatrics, Fujita Health University School of Medicine, 1-98, Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan.
Graduate School of Health Sciences, Fujita Health University, Toyoake, Aichi, Japan.
出版信息
BMC Pediatr. 2018 Feb 12;18(1):51. doi: 10.1186/s12887-018-1027-9.
BACKGROUND
Respiratory syncytial virus (RSV) infection is common and may be severe among patients with preexisting cardiac anomalies, but direct involvement of myocardial damage is not common in those patients. Additionally, myocardial involvement has been rarely described among immune compromised children.
CASE PRESENTATION
A 4-year-old girl with acute lymphoblastic leukemia who received maintenance chemotherapy in an outpatient clinic developed systemic inflammatory response syndrome. RSV infection was confirmed by a positive rapid antigen test and serological assay. Subsequently, she was diagnosed with severe myocarditis caused by RSV infection, which was diagnosed by abnormal findings of cardiac echography and ECG and elevated biomarkers for myocardial damage. Then, she was treated in the intensive care unit for 13 days. High amounts of RSV type B RNA was detected in tracheal aspirates and serum sample.
CONCLUSION
This case report emphasizes that RSV infection may be associated with myocarditis in immunocompromised children receiving maintenance chemotherapy.
背景
呼吸道合胞病毒（RSV）感染很常见，在患有先天性心脏异常的患者中可能较为严重，但这些患者中心肌直接受损并不常见。此外，免疫功能低下的儿童中心肌受累的情况鲜有报道。
病例介绍
一名4岁急性淋巴细胞白血病女童在门诊接受维持化疗时出现全身炎症反应综合征。快速抗原检测和血清学检测均证实为RSV感染。随后，她被诊断为RSV感染所致的重症心肌炎，通过心脏超声和心电图的异常表现以及心肌损伤生物标志物升高得以确诊。之后，她在重症监护病房接受了13天的治疗。在气管吸出物和血清样本中检测到大量B型RSV RNA。
结论
本病例报告强调，RSV感染可能与接受维持化疗的免疫功能低下儿童的心肌炎有关。
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