Prevalence and Implications of Coxsackie Virus in Myopericarditis, Prospective Tertiary Care Study

Abstract

The serological prevalence of coxsackie virus in myocarditis, pericarditis and myopericarditis is largely unknown in our population. The implications of coxsackie virus as causative agent in myopericarditis has not been studied so far in our population. AIMS AND OBJECTIVESThe aims and objectives of this study were to study the serological prevalence of Coxsackie virus in acute pericarditis and myocarditis in a Tertiary Centre and to study the clinical profile of Coxsackie myopericarditis. MATERIAL AND METHODSOur study was a prospective study done from November 2010 -October 2012, the samples were taken from 40 patients with the diagnosed cases of myocarditis, pericarditis and myopericarditis. Myocarditis and pericarditis were diagnosed as per standard guidelines, Enzyme Immunoassay (ELISA) for the determination of IgM antibodies to Coxsackie virus B (CoxB) in human acute and convalescent sera was done. RESULTSOur study comprised of forty patients with mean age of 35.3 years with M:F ratio of 1.35. Among the 40 patients 11 patients were diagnosed with pericarditis (27.50%), 14 with myocarditis (35.00%) and 15 patients with myopericarditis (37.50%). Among the 40 studied patients, 15 were positive for Coxsackie serology. Among the serology positive patients, 6 had diagnosis of myopericarditis (40.00%), 6 had diagnosis of myocarditis (40.00%) and 3 had diagnosis of pericarditis (20.00%). The clinical features of coxsackie positive and negative individuals did not differ significantly; breathlessness (93% vs 76%), chest pain (73% vs 76%), fever (60% vs 60%), cough (46 vs 32%), CCF (53 vs 48%) respectively. Ejection fraction less than 45% was seen in 40% of positive vs 32% of serology negative patients. CONCLUSIONCoxsackie virus as an aetiological factor was found in about one-third of cases of acute myopericarditis. However, the clinical presentation and echocardiographic characteristics did not differ from Coxsackie negative myopericarditis.