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Volume 23, Number 9—September 2017
Dispatch

Myocarditis Caused by Human Parechovirus in Adult

Khai Lin KongComments to Author , Jillian S.Y. Lau, Su Mei Goh, Heather L. Wilson, Mike Catton, and Tony M. Korman
Author affiliations: Monash University, Clayton, Victoria, Australia (K.L. Kong, J.S.Y. Lau, S.M. Goh, T.M. Korman); Monash Health, Clayton (K.L. Kong, J. Lau, S.M. Goh, T.M. Korman); Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia (H.L. Wilson, M. Catton)

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Table

Characteristics of 5 patients with myocarditis caused by infection with human parechovirus*

Patient (reference) Age/sex Underlying disease Clinical features Sample in which virus was detected Subtype Echocardiographic finding Therapy Outcome
1 (11) NA/M NA NA Stool, blood 1† NA NA NA
2 (13) 14 mo/M Congenital AGG Myocarditis Myocardium, pericardial fluid 1† NA None Died
3 (14) 6 wk/M None Myocarditis Stool 1† NA None Survived
4 (12) 16 y/F SLE, rituximab-induced HGG Myocarditis, encephalitis Myocardium, CSF, stool 3 Biventricular dysfunction, LVEF 13% IVIG Survived, prolonged neurologic recovery
5 (this study) 26 y/M None Myocarditis Throat swab specimen Unknown Dilated left ventricle, LVEF 15% None Survived, Well at 6-mo follow up

*AGG, agammaglobulinemia; CSF, cerebrospinal fluid; HGG, hypogammaglobulinemia; IVIG, intravenous immunoglobulin; LVEF, left ventricular ejection fraction; NA, not available; SLE, systemic lupus erythematosus.
†Previously known as echovirus subtype 22.

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References
  1. Papadakis  G, Tsortos  A, Kordas  A, Tiniakou  I, Morou  E, Vontas  J, et al. Acoustic detection of DNA conformation in genetic assays combined with PCR. Sci Rep. 2013;3:2033. DOIPubMedGoogle Scholar
  2. Nix  WA, Maher  K, Pallansch  MA, Oberste  MS. Parechovirus typing in clinical specimens by nested or semi-nested PCR coupled with sequencing. J Clin Virol. 2010;48:202–7. DOIPubMedGoogle Scholar
  3. de Crom  SCM, Rossen  JWA, van Furth  AM, Obihara  CC. Enterovirus and parechovirus infection in children: a brief overview. Eur J Pediatr. 2016;175:1023–9. DOIPubMedGoogle Scholar
  4. Khatami  A, McMullan  BJ, Webber  M, Stewart  P, Francis  S, Timmers  KJ, et al. Sepsis-like disease in infants due to human parechovirus type 3 during an outbreak in Australia. Clin Infect Dis. 2015;60:228–36. DOIPubMedGoogle Scholar
  5. Mizuta  K, Kuroda  M, Kurimura  M, Yahata  Y, Sekizuka  T, Aoki  Y, et al. Epidemic myalgia in adults associated with human parechovirus type 3 infection, Yamagata, Japan, 2008. Emerg Infect Dis. 2012;18:1787–93. DOIPubMedGoogle Scholar
  6. Saikruang  W, Khamrin  P, Suantai  B, Okitsu  S, Hayakawa  S, Ushijima  H, et al. Detection of diarrheal viruses circulating in adult patients in Thailand. Arch Virol. 2014;159:3371–5. DOIPubMedGoogle Scholar
  7. Figueroa  JP, Ashley  D, King  D, Hull  B. An outbreak of acute flaccid paralysis in Jamaica associated with echovirus type 22. J Med Virol. 1989;29:315–9. DOIPubMedGoogle Scholar
  8. Sedmak  G, Nix  WA, Jentzen  J, Haupt  TE, Davis  JP, Bhattacharyya  S, et al. Infant deaths associated with human parechovirus infection in Wisconsin. Clin Infect Dis. 2010;50:357–61. DOIPubMedGoogle Scholar
  9. Harvala  H, McLeish  N, Kondracka  J, McIntyre  CL, McWilliam Leitch  EC, Templeton  K, et al. Comparison of human parechovirus and enterovirus detection frequencies in cerebrospinal fluid samples collected over a 5-year period in edinburgh: HPeV type 3 identified as the most common picornavirus type. J Med Virol. 2011;83:889–96. DOIPubMedGoogle Scholar
  10. Knowlton  KU, Narexkina  A, Savoia  MC, Oxman  MN. Myocarditis and pericarditis. In: Bennett JE, Dolin R, Blaser MJ, editors. Mandell, Douglas, and Bennett’s principles and practice of infectious diseases. 8th ed. Amsterdam: Elsevier; 2015. p. 1066–79.
  11. Ehrnst  A, Eriksson  M. Epidemiological features of type 22 echovirus infection. Scand J Infect Dis. 1993;25:275–81. DOIPubMedGoogle Scholar
  12. Mardekian  SK, Fortuna  D, Nix  A, Bhatti  T, Wiley  CA, Flanders  A, et al. Severe human parechovirus type 3 myocarditis and encephalitis in an adolescent with hypogammaglobulinemia. Int J Infect Dis. 2015;36:6–8. DOIPubMedGoogle Scholar
  13. Maller  HM, Powars  DF, Horowitz  RE, Portnoy  B. Fatal myocarditis associated with ECHO virus, type 22, infection in a child with apparent immunological deficiency. J Pediatr. 1967;71:204–10. DOIPubMedGoogle Scholar
  14. Russell  SJ, Bell  EJ. Echoviruses and carditis. Lancet. 1970;1:784–5. DOIPubMedGoogle Scholar
  15. Dendle  C, Gilbertson  M, Korman  TM, Golder  V, Morand  E, Opat  S. Disseminated enteroviral infection associated with obinutuzumab. Emerg Infect Dis. 2015;21:1661–3. DOIPubMedGoogle Scholar

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Page created: August 17, 2017
Page updated: August 17, 2017
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The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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