First report on fatal myocarditis associated with adenovirus infection in Cuba

Valdés, Odalys; Acosta, Belsy; Piñón, Alexander; Savón, Clara; Goyenechea, Angel; González, Grehete; González, Guelsys; Palerm, Lídice; Sarmiento, Luis; Pedro, Más Lago; Martínez, Pedro A.; Rosario, Delfina; Kourí, Vivian; Guzmán, María G.; Llop, Alina; Casas, Inmaculada; Brena, M. P. P.

doi:10.1002/jmv.21274

Cited by 20 publications

(11 citation statements)

References 33 publications

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“…Quantification of viral load may help to resolve this problem. Several studies showed that types 1, 2, 3, 5 and 21 are associated with myocarditis in children [16]. Fatal cases of HAdV-3 myocarditis have been reported by Treacy et al [15].…”

Section: Discussionmentioning

confidence: 96%

Genotyping of human adenoviruses circulating in Southwest India

et al. 2016

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Adenoviruses are found to be associated with a wide range of diseases in children and adults. There is little data available on the circulating serotypes of Human Adenoviruses (HAdVs) in the southwest region of India. In this study, we explore the molecular epidemiology of HAdVs circulating in southwest India. Twenty-three samples (Adenovirus PCR positive), collected between January 2011 and March 2013, have been typed based on the partial hexon gene sequence and phylogenetic analysis. The commonest serotypes were HAdV-3 and HAdV-2. The other serotypes were HAdV-7, HAdV-1, HAdV-8 and HAdV-40. Respiratory illness was the most common clinical manifestation of HAdV-3, HAdV-2 and HAdV-7 serotypes. HAdV-3, HAdV-7 and HAdV-8 were found to cause conjunctivitis, whereas HAdV-1, HAdV-2 and HAdV-3 caused encephalitis. In conclusion, this study documents the circulating HAdV strains and the epidemiology in southwest India. To the best of our knowledge, this is the first study on the molecular epidemiology of HAdVs in India.

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Section: Discussionmentioning

confidence: 96%

Genotyping of human adenoviruses circulating in Southwest India

et al. 2016

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“…Recently, in Cuba, an outbreak of febrile syndrome followed by acute cardiac decompensation in infants and young children has been described (13,15). In six of the eight fatal cases, adenoviral DNA was detected in the lungs and myocardium.…”

Section: Case Reportmentioning

confidence: 99%

First Report of Sudden Death Due to Myocarditis Caused by Adenovirus Serotype 3

et al. 2010

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Myocarditis is a rare cause of sudden death in childhood. We describe the sudden death of a child from viral myocarditis, which we demonstrate was likely caused by an uncontrolled inflammatory response to a disseminated adenovirus serotype 3 infection originating in the tonsil. CASE REPORTAn 11-year old boy collapsed suddenly at home. He was transferred to a hospital by ambulance. Cardiopulmonary resuscitation was unsuccessful, and he was pronounced dead. He had visited his general practitioner (GP) 1 day earlier with a sore throat and was treated with antibiotics for tonsillitis. No investigations were carried out by his GP or on arrival at the hospital due to his sudden death. He had no past medical history of note, and there was no family history of cardiac illness or sudden death. No recent foreign travel was reported, nor was there contact with persons from abroad. A postmortem was carried out at the direction of the coroner.Much of the postmortem examination was normal. His tonsils were mildly enlarged and showed a surface purulent exudate. However, on postmortem examination, his heart was enlarged (weight, 214.2 g; expected weight, 124 g). On sectioning, the myocardium appeared diffusely abnormal with areas of petechiae and pallor. There was no evidence of myocardial hypertrophy. Microscopically, there was a severe myocardial infiltrate diffusely present composed of lymphocytes, histiocytes, and plasma cells with occasional eosinophils and neutrophils (Fig. 1). There were admixed areas of necrosis and hemorrhage. There was no evidence of fibrosis or myofiber hypertrophy. Immunohistochemical staining revealed that the infiltrate was predominantly lymphohistiocytic (CD45 positive). CD3 staining confirmed that this was a T-lymphocytemediated response (Fig. 2).All routine investigations, including swabs for bacterial culture, blood cultures, meningococcal PCR, and pneumococcal PCR, were negative. Toxicology testing for alcohol and drugs was negative. Target-specific immunoglobulin M assays were performed for Mycoplasma pneumoniae, cytomegalovirus, Epstein-Barr virus, parvovirus B19, and rubella virus, along with complement fixation testing for total antibodies to Mycoplasma pneumoniae, Chlamydia group, and adenovirus and latex agglutination testing for Toxoplasma gondii. All serological investigations were negative. In addition, no viruses were observed in the lung or myocardial tissue by electron microscopy. Cerebrospinal fluid Gram staining and culture were negative.The most common viral etiologies of myocarditis are Coxsackie group B viruses and members of the adenovirus genus (3, 5). Therefore, molecular methods were employed to investigate the presence of these viruses. Total viral RNA/DNA was extracted from serum using the Qiagen QIAmp viral RNA mini kit, and total viral DNA was extracted from myocardial and pulmonary tissue using the QIAamp DNA mini kit (Qiagen) in accordance with the manufacturer's instructions. Enterovirus RNA was not detected in lung or myocardial tissue using a nested reverse trans...

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“…Other viruses that cause myocarditis are adenovirus, influenza, parvovirus B19, members of the Herpesviridae family, cytomegalovirus (CMV), and human herpesvirus 6 (HHV-6) have all been associated occasionally with myocarditis [11]. Viral genomes are frequently detected by polymerase chain reaction enhancement in endomyocardial biopsies of patients with systolic left ventricular dysfunction and this may play a role in the pathogenesis of cardiomyopathy far more frequently [12,13].…”

Section: Discussionmentioning

confidence: 99%

Unusual association of ST-T abnormalities, myocarditis and cardiomyopathy with H1N1 influenza in pregnancy: two case reports and review of the literature

2011

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IntroductionMyocarditis is rarely reported as an extra-pulmonary manifestation of influenza while pregnancy is a rare cause of cardiomyopathy. Pregnancy was identified as a major risk factor for increased mortality and morbidity due to H1N1 influenza in the pandemic of 2009 to 2010. However, to the best of our knowledge there are no previous reports in the literature linking H1N1 with myocarditis in pregnancy.Case presentationWe report the cases of two pregnant Caucasian women (aged 29 and 30), with no pre-existing illness, presenting with respiratory manifestations of H1N1 influenza virus infection in their third trimester. Both women developed evidence of myocarditis. One woman developed acute respiratory distress syndrome, almost reaching the point of requiring extra-corporeal membrane oxygenation, and subsequently developed persistent cardiomyopathy; the other recovered without any long-term consequence.ConclusionsWhile it is not possible to ascertain retrospectively if myocarditis was caused by either infection with H1N1 virus or as a result of pregnancy (in the absence of endomyocardial biopsies), the significant association with myocardial involvement in both women demonstrates the increased risk of exposure to H1N1 influenza virus in pregnant women. This highlights the need for health care providers to increase awareness amongst caregivers to target this 'at risk' group aggressively with vaccination and prompt treatment.

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First report on fatal myocarditis associated with adenovirus infection in Cuba

Cited by 20 publications

References 33 publications

Genotyping of human adenoviruses circulating in Southwest India

Genotyping of human adenoviruses circulating in Southwest India

First Report of Sudden Death Due to Myocarditis Caused by Adenovirus Serotype 3

Unusual association of ST-T abnormalities, myocarditis and cardiomyopathy with H1N1 influenza in pregnancy: two case reports and review of the literature

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