Medical Microbiology & Diagnosis

A Rare Case of Acute Myocarditis

Abstract

Karoly Peter Sarvari, Szilard Zolyomi, Gergely Agoston, Gabriella Terhes, Henriette Gavaller, Tamas Forster, Albert Varga and Edit Urban

Acute myocarditis is an inflammatory disease with a quite broad range of consequences caused mostly by viruses. Epstein-Barr virus (EBV) rarely causes acute myocarditis. A 19-year-old healthy man with sudden epigastrial and chest pain was admitted to hospital. Laboratory investigations suspected acute myocardial infarct, but MRI and echocardiography showed myocardial oedema as part of inflammation. In his past medical history, toxic exposition and travelling abroad could not be recorded. PCR investigations of the most common viruses causing acute myocarditis gave negative results, but positive EBV anti-VCA IgM, and later sero conversion could be detected and simultaneously, a typical mononucleosis proved the aetiological role of EBV. After a 3-week-long high dose NSAID therapy on the basis of beta-blocker and ACE-inhibitor therapy, on control MRI oedema disappeared, but electrocardiography was still positive, the patient with satisfying general status was discharged home. On the 6 month control MRI, neither any signs of myocarditis, nor decreased systolic ejection fraction were noted, and also ECG turned negative.