Parvovirus B19 infection in 65 children was complicated by myocardial injury, presenting as asymptomatic troponinemia in 80%, acute myocarditis in 10.8%, and fulminant myocarditis in 9.2%.
Observational (n=65)
Parvovirus B19 outbreaks can be associated with a high incidence of myocardial injury in children, ranging from asymptomatic troponinemia to life-threatening fulminant myocarditis.
Background: Parvovirus B19 (B19V) has frequently been followed by cardiac involvement in the form of myocarditis, with potential progression towards dilated cardiomyopathy. In children, B19V-related myocarditis is associated with high morbidity and mortality. Methods: We describe a cluster of cases of B19V infections complicated with myocardial injury that presented either as transient asymptomatic elevation of cardiac troponin or as full-blown myocarditis in young children. These cases emerged during an outbreak of B19V infections in spring/summer 2024 in Northern Greece. In addition, a scoping review of pertinent published case reports and case series was conducted. Results: After a fatal index myocarditis case in a 3.5-year-old girl complicating B19V infection, 65 children who had a clinically diagnosed and/or microbiologically confirmed B19V infection presented with myocardial injury of various degrees. Increased high-sensitivity troponin levels without any myocarditis symptoms or signs were found in 52/65 (80%) children. Seven (10.8%) had self-limiting acute myocarditis with high troponin levels and 6 (9.2%) were diagnosed with fulminant myocarditis, of which 2 had a fatal outcome. Median age of all participants was 4.0 interquartile range (IQR) 3.0–6.5 years. Median troponin in 6 children with dilated cardiomyopathy was 1900 (IQR 575–4500) ng/L, while in asymptomatic children it was 129.5 (IQR 89.5–244) ng/L. Thirty-two relevant studies, mainly case reports or small series, were found with an additional 191 cases (≥60 fatalities). Conclusions: Emergence of myocardial injury during outbreaks of B19V infections may occur. Awareness of this cardiac complication may facilitate early optimal management of rare but life-threatening complications, such as fulminant myocarditis.
Kavga et al. (Tue,) conducted a observational in Parvovirus B19 infection with myocardial injury (n=65). Parvovirus B19 infection was evaluated on Myocardial injury severity (asymptomatic troponinemia, acute myocarditis, fulminant myocarditis). Parvovirus B19 infection in 65 children was complicated by myocardial injury, presenting as asymptomatic troponinemia in 80%, acute myocarditis in 10.8%, and fulminant myocarditis in 9.2%.