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A Case of Influenza Associated Fulminant Myocarditis Successfully Treated with Intravenous Peramivir

We report the case of a patient with fulminant myocarditis caused by influenza A virus, who presented with acute-onset heart failure and cardiogenic shock and was treated successfully with single dose of intravenous peramivir and with pharmacologic hemodynamic support. A 45-year-old Korean woman pre...

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Autores principales: Baik, Seung Hee, Jeong, Han Saem, Kim, Sun Jin, Yoon, Young Kyung, Sohn, Jang Wook, Kim, Min Ja
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Society of Infectious Diseases and Korean Society for Chemotherapy 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4716281/
https://www.ncbi.nlm.nih.gov/pubmed/26788413
http://dx.doi.org/10.3947/ic.2015.47.4.272
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author Baik, Seung Hee
Jeong, Han Saem
Kim, Sun Jin
Yoon, Young Kyung
Sohn, Jang Wook
Kim, Min Ja
author_facet Baik, Seung Hee
Jeong, Han Saem
Kim, Sun Jin
Yoon, Young Kyung
Sohn, Jang Wook
Kim, Min Ja
author_sort Baik, Seung Hee
collection PubMed
description We report the case of a patient with fulminant myocarditis caused by influenza A virus, who presented with acute-onset heart failure and cardiogenic shock and was treated successfully with single dose of intravenous peramivir and with pharmacologic hemodynamic support. A 45-year-old Korean woman presented to our emergency department (ED) with shortness of breath and an episode of seizure that developed abruptly 5 hours before she arrived in the ED. She had a history of recurrent epileptic seizure 25 years ago, but denied other specific medical illnesses. In the ED, she was hypoxemic (arterial partial pressure of oxygen, 59.8 mmHg on room air) and chest radiography revealed bilateral alveolar infiltrates. A rapid antigen test for influenza A virus was positive, and she was administered a single dose of peramivir (300 mg) intravenously. Five hours later, the patient's dyspnea had worsened and she was hypotensive (blood pressure, 86/53 mmHg), requiring norepinephrine infusion. Further evaluation disclosed an increased cardiac troponin I level of 1.36 ng/mL and a depressed left ventricular ejection fraction of 30%. Under the diagnosis of influenza A-associated myocarditis and cardiogenic shock, she was managed with continuous critical care in the intensive care unit. On day 3, the patient's dyspnea began to resolve and her ventricular function returned to normal. Real-time polymerase chain reaction assays for influenza viruses in serial nasopharyngeal aspirates were positive for influenza A (hH3N2) with a threshold cycle value of 27.39 on day 2, but these became negative by day 4. The patient recovered and was discharged on day 9 after admission. In conclusion, this case indicates that intravenous peramivir might be an effective antiviral agent for the treatment of severe influenza A virus infection.
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spelling pubmed-47162812016-01-19 A Case of Influenza Associated Fulminant Myocarditis Successfully Treated with Intravenous Peramivir Baik, Seung Hee Jeong, Han Saem Kim, Sun Jin Yoon, Young Kyung Sohn, Jang Wook Kim, Min Ja Infect Chemother Case Report We report the case of a patient with fulminant myocarditis caused by influenza A virus, who presented with acute-onset heart failure and cardiogenic shock and was treated successfully with single dose of intravenous peramivir and with pharmacologic hemodynamic support. A 45-year-old Korean woman presented to our emergency department (ED) with shortness of breath and an episode of seizure that developed abruptly 5 hours before she arrived in the ED. She had a history of recurrent epileptic seizure 25 years ago, but denied other specific medical illnesses. In the ED, she was hypoxemic (arterial partial pressure of oxygen, 59.8 mmHg on room air) and chest radiography revealed bilateral alveolar infiltrates. A rapid antigen test for influenza A virus was positive, and she was administered a single dose of peramivir (300 mg) intravenously. Five hours later, the patient's dyspnea had worsened and she was hypotensive (blood pressure, 86/53 mmHg), requiring norepinephrine infusion. Further evaluation disclosed an increased cardiac troponin I level of 1.36 ng/mL and a depressed left ventricular ejection fraction of 30%. Under the diagnosis of influenza A-associated myocarditis and cardiogenic shock, she was managed with continuous critical care in the intensive care unit. On day 3, the patient's dyspnea began to resolve and her ventricular function returned to normal. Real-time polymerase chain reaction assays for influenza viruses in serial nasopharyngeal aspirates were positive for influenza A (hH3N2) with a threshold cycle value of 27.39 on day 2, but these became negative by day 4. The patient recovered and was discharged on day 9 after admission. In conclusion, this case indicates that intravenous peramivir might be an effective antiviral agent for the treatment of severe influenza A virus infection. The Korean Society of Infectious Diseases and Korean Society for Chemotherapy 2015-12 2015-12-30 /pmc/articles/PMC4716281/ /pubmed/26788413 http://dx.doi.org/10.3947/ic.2015.47.4.272 Text en Copyright © 2015 by The Korean Society of Infectious Diseases and Korean Society for Chemotherapy http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Baik, Seung Hee
Jeong, Han Saem
Kim, Sun Jin
Yoon, Young Kyung
Sohn, Jang Wook
Kim, Min Ja
A Case of Influenza Associated Fulminant Myocarditis Successfully Treated with Intravenous Peramivir
title A Case of Influenza Associated Fulminant Myocarditis Successfully Treated with Intravenous Peramivir
title_full A Case of Influenza Associated Fulminant Myocarditis Successfully Treated with Intravenous Peramivir
title_fullStr A Case of Influenza Associated Fulminant Myocarditis Successfully Treated with Intravenous Peramivir
title_full_unstemmed A Case of Influenza Associated Fulminant Myocarditis Successfully Treated with Intravenous Peramivir
title_short A Case of Influenza Associated Fulminant Myocarditis Successfully Treated with Intravenous Peramivir
title_sort case of influenza associated fulminant myocarditis successfully treated with intravenous peramivir
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4716281/
https://www.ncbi.nlm.nih.gov/pubmed/26788413
http://dx.doi.org/10.3947/ic.2015.47.4.272
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