Document Detail

Cardiogenic shock in a neonate with enterovirus myocarditis.
MedLine Citation:
PMID:  20013569     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Left ventricular compromise in the neonate may be caused by birth asphyxia, metabolic disease, congenital heart disease, and systemic bacterial or viral infections. In rare cases, enterovirus infection may cause severe disease including cardiac, cerebral, hepatic and multi organ failure. PATIENTS AND METHODS: Case report. RESULTS: A 3-week-old neonate was admitted to our NICU in cardiogenic shock and severe lactic acidosis (ph: 6.9; serum lactate: 15 mmol/l, base excess: -19.8 mmol/l; pCO (2): 54.9 mm Hg). Serum troponin T was within the normal range; serum total creatinin phosphokinase was 57 U/l, CK-MB 110 U/l, LDH 762 U/l; pro-BNP: 64391 pg/ml was elevated. On echocardiography left ventricular function was depressed with a shortening fraction of 16%. The neonate was started on inotropes. There was gradual improvement over the following two weeks with normalisation of left ventricular output. PCR examination was positive for enterovirus. Other causes for left ventricular compromise (congenital heart disease, inborn errors of metabolism, etc.) were ruled out by adequate means. CONCLUSIONS: Enterovirus infection as a cause for myocarditis and cardiogenic shock should be taken into the differential diagnosis in neonates.
S Meyer; L Gortner; S Gottschling; B G?rtner; H Abdul-Khaliq
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Publication Detail:
Type:  Editorial    
Journal Detail:
Title:  Klinische P?diatrie     Volume:  221     ISSN:  1439-3824     ISO Abbreviation:  Klin Padiatr     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-12-16     Completed Date:  2010-03-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0326144     Medline TA:  Klin Padiatr     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  444-7     Citation Subset:  IM    
Copyright Information:
(c) Georg Thieme Verlag KG Stuttgart New York.
Department of Neonatology and Pediatric Intensive Care Medicine, University Hospital of Saarland, Homburg, Germany.
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MeSH Terms
Bacteremia / diagnosis
Diagnosis, Differential
Echocardiography, Doppler
Enterovirus Infections / diagnosis*,  transmission
Infant, Newborn
Infectious Disease Transmission, Vertical
Intensive Care Units, Neonatal
Mitral Valve Insufficiency / diagnosis
Myocarditis / diagnosis*
Polymerase Chain Reaction
Pregnancy Complications, Infectious / diagnosis
Shock, Cardiogenic / diagnosis*,  etiology*
Ventricular Dysfunction, Left / diagnosis

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