Source: Annual Congress 2010 - Influenza A (H1N1) and other viral infections: therapeutic aspects
Disease area: Respiratory infections

Abstract

Aims: The main cause of death from novel (swine origin) influenza A H1N1 infection is acute respiratory distress syndrome. Most fatal cases are immunocompromised patients or patients with a severe underlying disease. Here, we report a fatal case of acute interstitial myocarditis associated with novel influenza A/H1N1 infection in an immunocompetent young woman. Methods: Autopsy, (nested) RT-PCR analysis, sequencing, immunohistochemistry, electron microscopy. Results: A previously healthy 18-year-old woman experienced malaise, diarrhea, and fever for several days before a sudden collapse at home. Autopsy revealed an acute interstitial myocarditis in absence of a significant respiratory tract infection. Infection with novel (swine origin) influenza A (H1N1) was confirmed by PCR analysis of blood as well as myocardial tissue. Influenza-caused diarrhea with consecutive hypokalemia potentially contributed to the fatal outcome of the myocarditis leading to ventricular fibrillation. Conclusions: Sudden death by myocarditis may be a rare complication of novel influenza A H1N1 infection in otherwise healthy individuals, even in the absence of significant respiratory tract infection.

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G. Gdynia, P. Schnitzler, R. Kandolf, H. Bläker, P. A. Schnabel, P. Schirmacher, W. Roth (Heidelberg, Tübingen, Germany). Sudden death of an immunocompetent young adult caused by novel (swine origin) influenza A/H1N1-associated myocarditis. Eur Respir J 2010; 36: Suppl. 54, 2992

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