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AJP Rep. 2017 Apr;7(2):e124-e126. doi: 10.1055/s-0037-1601352. Epub 2017 Jun 29.

Peculiar Clinical Presentation of Coxsackievirus B4 Infection: Neonatal Restrictive Cardiomyopathy.

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Departement de Pathologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
Service de Pédiatrie, Centre Hospitalier Universitaire Pointe-à-Pitre/Abymes, Pointe-à-Pitre, France.
Unité de Cardiopédiatrie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
Service de Virologie, Plateau Technique de Microbiologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
Faculté de Médecine, Université de Strasbourg, Strasbourg, France.


Introduction  Restrictive cardiomyopathy in fetuses and neonates is extremely rare and has a poor outcome. Its etiology in neonates is elusive: metabolic diseases (e.g., Gaucher, Hurler syndrome), neuromuscular disorders (e.g., muscular dystrophies, myofibrillar myopathies), or rare presentation of genetic syndromes (e.g., Coffin-Lowry syndrome) account for a minority of the cases, the majority remaining idiopathic. Case Study  We report the case of a 17-day-old male infant presenting cardiogenic shock following a restrictive dysfunction of the left ventricle. Postmortem investigations revealed coxsackievirus B4 myocarditis with histological lesions limited to the left heart. However, polymerase chain reaction (PCR) for coxsackievirus B4 was positive in the left as well as in the right ventricular samples. Conclusion  In conclusion, coxsackievirus myocarditis is a cause of restrictive cardiomyopathy, and its diagnosis should involve PCR screening as a more sensitive technique.


PCR; coxsackievirus B4; neonate; restrictive cardiomyopathy

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