Successful management of fulminant influenza A subtype H1N1 myocarditis

BMJ Case Rep. 2010 Sep 17:2010:bcr0220102763. doi: 10.1136/bcr.02.2010.2763.

Abstract

The outbreak and spread of the new influenza A subtype H1N1 reached pandemic levels during 2009, with greater numbers of cases reported daily and numerous complications described. The present report concerns an atypical manifestation of the disease in a previously healthy middle-aged patient who presented with severe, refractory cardiogenic shock 4 days after being diagnosed as having influenza A. The patient was considered for emergency heart transplant. Successful treatment involved the use of a left ventricular assist device, extracorporeal membrane oxygenation, intravenous immunoglobulin and peramivir as therapeutics and bridging therapies for transplant. This case is a report of H1N1 fulminant myocarditis and illustrates the usefulness of a multidisciplinary approach in the care of these patients.

Publication types

  • Case Reports

MeSH terms

  • Acids, Carbocyclic
  • Antiviral Agents / therapeutic use
  • Combined Modality Therapy
  • Cyclopentanes / therapeutic use
  • Extracorporeal Membrane Oxygenation
  • Female
  • Guanidines / therapeutic use
  • Humans
  • Immunoglobulins, Intravenous / therapeutic use
  • Influenza A Virus, H1N1 Subtype*
  • Influenza, Human / complications*
  • Influenza, Human / therapy
  • Middle Aged
  • Myocarditis / etiology*
  • Myocarditis / therapy
  • Shock, Cardiogenic / etiology
  • Shock, Cardiogenic / therapy

Substances

  • Acids, Carbocyclic
  • Antiviral Agents
  • Cyclopentanes
  • Guanidines
  • Immunoglobulins, Intravenous
  • peramivir