A Fatal Case of Influenza B Myocarditis with Cardiac Tamponade

Background. Influenza B is generally regarded as a less severe counterpart to influenza A, typically causing mild upper respiratory symptoms. Myocardial involvement with influenza B is a rare complication, better described in children than adults. However, when it occurs, it can lead to profound myo...

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Main Authors: Dominick Roto, Michelle L. Malnoske, Shira Winters, Steve N. Georas
Format: Article
Language:English
Published: Wiley 2018-01-01
Series:Case Reports in Critical Care
Online Access:http://dx.doi.org/10.1155/2018/8026314
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author Dominick Roto
Michelle L. Malnoske
Shira Winters
Steve N. Georas
author_facet Dominick Roto
Michelle L. Malnoske
Shira Winters
Steve N. Georas
author_sort Dominick Roto
collection DOAJ
description Background. Influenza B is generally regarded as a less severe counterpart to influenza A, typically causing mild upper respiratory symptoms. Myocardial involvement with influenza B is a rare complication, better described in children than adults. However, when it occurs, it can lead to profound myocarditis with progression to shock requiring aggressive supportive care. Case Presentation. We present a case of cardiac tamponade in the setting of influenza B infection in a previously healthy 57-year-old woman, with progression to refractory shock and death. Autopsy revealed myocardial necrosis with infiltration of CD3+ lymphocytes, and little evidence of viral pneumonia. Conclusions. Myocarditis is a rare complication of influenza B in adults, and subsequent pericardial effusion with tamponade physiology is a previously unreported event in an otherwise healthy adult without other medical comorbidities. While rare, this is a serious and potentially fatal complication that clinicians should be aware of when evaluating a patient with suspected viral illness who is exhibiting shock physiology.
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spelling doaj-art-8862d3a581654c59b51f9b1774bb4be72025-08-20T02:09:11ZengWileyCase Reports in Critical Care2090-64202090-64392018-01-01201810.1155/2018/80263148026314A Fatal Case of Influenza B Myocarditis with Cardiac TamponadeDominick Roto0Michelle L. Malnoske1Shira Winters2Steve N. Georas3Department of Medicine, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY 14642, USADivision of Pulmonary and Critical Care, Department of Medicine, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY 14642, USADepartment of Pathology, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY 14642, USADivision of Pulmonary and Critical Care, Department of Medicine, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY 14642, USABackground. Influenza B is generally regarded as a less severe counterpart to influenza A, typically causing mild upper respiratory symptoms. Myocardial involvement with influenza B is a rare complication, better described in children than adults. However, when it occurs, it can lead to profound myocarditis with progression to shock requiring aggressive supportive care. Case Presentation. We present a case of cardiac tamponade in the setting of influenza B infection in a previously healthy 57-year-old woman, with progression to refractory shock and death. Autopsy revealed myocardial necrosis with infiltration of CD3+ lymphocytes, and little evidence of viral pneumonia. Conclusions. Myocarditis is a rare complication of influenza B in adults, and subsequent pericardial effusion with tamponade physiology is a previously unreported event in an otherwise healthy adult without other medical comorbidities. While rare, this is a serious and potentially fatal complication that clinicians should be aware of when evaluating a patient with suspected viral illness who is exhibiting shock physiology.http://dx.doi.org/10.1155/2018/8026314
spellingShingle Dominick Roto
Michelle L. Malnoske
Shira Winters
Steve N. Georas
A Fatal Case of Influenza B Myocarditis with Cardiac Tamponade
Case Reports in Critical Care
title A Fatal Case of Influenza B Myocarditis with Cardiac Tamponade
title_full A Fatal Case of Influenza B Myocarditis with Cardiac Tamponade
title_fullStr A Fatal Case of Influenza B Myocarditis with Cardiac Tamponade
title_full_unstemmed A Fatal Case of Influenza B Myocarditis with Cardiac Tamponade
title_short A Fatal Case of Influenza B Myocarditis with Cardiac Tamponade
title_sort fatal case of influenza b myocarditis with cardiac tamponade
url http://dx.doi.org/10.1155/2018/8026314
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