Limits...
Acute Myopericarditis caused by Human Metapneumovirus.

Choi MJ, Song JY, Yang TU, Jeon JH, Noh JY, Hong KW, Cheong HJ, Kim WJ - Infect Chemother (2016)

Bottom Line: The patient was diagnosed with human metapneumovirus infection, complicated by pneumonia and myopericarditis.With supportive care including oxygen supplementation, the patient recovered completely without any serious sequelae.Human metapneumovirus infection may contribute to the development of cardiovascular manifestations, particularly in the elderly population.

View Article: PubMed Central - PubMed

Affiliation: Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.

ABSTRACT
Human metapneumovirus is known to be similar to respiratory syncytial virus. Because of an incomplete protective immune response to new genotypes, re-infection occurs frequently, especially in the elderly. However, the clinical manifestations of human metapneumovirus need to be further characterized in adults. A 73-year-old woman presented to the emergency room with acute dyspnea, chest discomfort and influenza-like illness. The patient was diagnosed with human metapneumovirus infection, complicated by pneumonia and myopericarditis. With supportive care including oxygen supplementation, the patient recovered completely without any serious sequelae. Human metapneumovirus infection may contribute to the development of cardiovascular manifestations, particularly in the elderly population.

No MeSH data available.


Related in: MedlinePlus

Chest computed tomography shows ground-glass opacity in both lower lungs (A) and pericardial effusion with right-sided pleural effusion (B).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4835433&req=5

Figure 2: Chest computed tomography shows ground-glass opacity in both lower lungs (A) and pericardial effusion with right-sided pleural effusion (B).

Mentions: On physical examination the patient was slightly dyspneic with a heart rate of 72 beats/min, respiratory rate of 24 breaths/min, blood pressure of 160/77 mmHg and tympanic body temperature of 38.4℃. Lung auscultation revealed crackle in both lower lung fields. Initial laboratory tests showed mild leukopenia, thrombocytopenia, and anemia (Table 1). Serum C-reactive protein (97.57 mg/L) and erythrocyte sedimentation rate (52 mm/h) were elevated, but liver function tests were within normal limits. Hypoxia (oxygen saturation, 88% in room air) was observed on arterial blood gas analysis. Levels of creatine kinase-MB (CK-MB, 7.9 ng/mL) and Pro-B type natriurectic peptide (pro-BNP, 2618 pg/mL) were elevated. Chest X-ray showed cardiomegaly and diffuse opacity in both lower lungs (Fig. 1A). Electrocardiogram showed atrial fibrillation with a normal ventricular response, and echocardiography showed slightly decreased systolic function (ejection fraction, 50-55%) with a small amount of pericardial effusion that was not present 7 days previously at the time of diagnosis of atrial fibrillation. Chest computed tomography (CT) showed ground-glass opacities in bilateral lungs, right-sided pleural effusion, and pericardial effusion (Fig. 2). Ultrasound-guided aspiration of pleural effusion revealed a lymphocyte-dominant exudate with pH 7.0, WBC 560 cells/L with relative lymphocytosis (95%), glucose 104 mg/dL, protein 2.8 g/dL, lactate dehydrogenase (LDH) 356 IU/L and adenosine deaminase (ADA) 18.3 IU/L. Pericardiocentesis could not be performed because of safety concerns.


Acute Myopericarditis caused by Human Metapneumovirus.

Choi MJ, Song JY, Yang TU, Jeon JH, Noh JY, Hong KW, Cheong HJ, Kim WJ - Infect Chemother (2016)

Chest computed tomography shows ground-glass opacity in both lower lungs (A) and pericardial effusion with right-sided pleural effusion (B).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4835433&req=5

Figure 2: Chest computed tomography shows ground-glass opacity in both lower lungs (A) and pericardial effusion with right-sided pleural effusion (B).
Mentions: On physical examination the patient was slightly dyspneic with a heart rate of 72 beats/min, respiratory rate of 24 breaths/min, blood pressure of 160/77 mmHg and tympanic body temperature of 38.4℃. Lung auscultation revealed crackle in both lower lung fields. Initial laboratory tests showed mild leukopenia, thrombocytopenia, and anemia (Table 1). Serum C-reactive protein (97.57 mg/L) and erythrocyte sedimentation rate (52 mm/h) were elevated, but liver function tests were within normal limits. Hypoxia (oxygen saturation, 88% in room air) was observed on arterial blood gas analysis. Levels of creatine kinase-MB (CK-MB, 7.9 ng/mL) and Pro-B type natriurectic peptide (pro-BNP, 2618 pg/mL) were elevated. Chest X-ray showed cardiomegaly and diffuse opacity in both lower lungs (Fig. 1A). Electrocardiogram showed atrial fibrillation with a normal ventricular response, and echocardiography showed slightly decreased systolic function (ejection fraction, 50-55%) with a small amount of pericardial effusion that was not present 7 days previously at the time of diagnosis of atrial fibrillation. Chest computed tomography (CT) showed ground-glass opacities in bilateral lungs, right-sided pleural effusion, and pericardial effusion (Fig. 2). Ultrasound-guided aspiration of pleural effusion revealed a lymphocyte-dominant exudate with pH 7.0, WBC 560 cells/L with relative lymphocytosis (95%), glucose 104 mg/dL, protein 2.8 g/dL, lactate dehydrogenase (LDH) 356 IU/L and adenosine deaminase (ADA) 18.3 IU/L. Pericardiocentesis could not be performed because of safety concerns.

Bottom Line: The patient was diagnosed with human metapneumovirus infection, complicated by pneumonia and myopericarditis.With supportive care including oxygen supplementation, the patient recovered completely without any serious sequelae.Human metapneumovirus infection may contribute to the development of cardiovascular manifestations, particularly in the elderly population.

View Article: PubMed Central - PubMed

Affiliation: Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.

ABSTRACT
Human metapneumovirus is known to be similar to respiratory syncytial virus. Because of an incomplete protective immune response to new genotypes, re-infection occurs frequently, especially in the elderly. However, the clinical manifestations of human metapneumovirus need to be further characterized in adults. A 73-year-old woman presented to the emergency room with acute dyspnea, chest discomfort and influenza-like illness. The patient was diagnosed with human metapneumovirus infection, complicated by pneumonia and myopericarditis. With supportive care including oxygen supplementation, the patient recovered completely without any serious sequelae. Human metapneumovirus infection may contribute to the development of cardiovascular manifestations, particularly in the elderly population.

No MeSH data available.


Related in: MedlinePlus