Repetitive Fulminant Influenza Myocarditis Requiring the Use of Circulatory Assist Devices

• Published in: Internal Medicine Vol. 53; no. 2; pp. 109 - 114
• Main Authors: Yoshimizu, Natsuko, Tominaga, Tomo, Ito, Takahide, Nishida, Yusuke, Wada, Yuki, Sohmiya, Koichi, Tanaka, Suguru, Shibata, Kensaku, Kanzaki, Yumiko, Ukimura, Akira, Morita, Hideaki, Hoshiga, Masaaki, Ishizaka, Nobukazu
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 01.01.2014
• Subjects: Adult; Antibodies, Viral - blood; Antiviral Agents - therapeutic use; cardiac support therapy; Catecholamines - therapeutic use; Cyclopentanes - therapeutic use; Dyspnea - etiology; Electrocardiography; fulminant myocarditis; Guanidines - therapeutic use; Heart-Assist Devices; Hemodynamics; Humans; Influenza A virus; Influenza A Virus, H3N2 Subtype - immunology; Influenza B virus - immunology; influenza virus; Influenza, Human - complications; Influenza, Human - drug therapy; Intra-Aortic Balloon Pumping; Magnetic Resonance Imaging; Male; Myocarditis - etiology; Myocarditis - surgery; Pericarditis - etiology; Recurrence; Ultrasonography; Ventricular Dysfunction, Left - diagnostic imaging; Ventricular Dysfunction, Left - etiology; viral myocarditis; Japan, Honshu, Tokyo Prefect., Tokyo
• ISSN: 0918-2918; 1349-7235
• DOI: 10.2169/internalmedicine.53.1117

A 52-year-old man was admitted to our hospital due to shortness of breath that developed one week after the diagnosis of influenza infection. He had a past history of myocarditis associated with influenza B infection 16 years before the current admission. The patient's left ventricular function showed diffuse hypokinesis with a left ventricular ejection fraction of 28%. Due to the progression of heart failure, the infusion of catecholamines and insertion of an intra-aortic balloon pump were required. The patient was discharged uneventfully on the 23rd hospital day. A significant increase in the serum antibody titer against influenza A virus subtype H3N2 led to a diagnosis of recurrent fulminant influenza myocarditis.