Key result
Mechanical circulatory support enables full cardiac recovery in fulminant dengue myocarditis.
Why the study?
Dengue myocarditis diagnosis is challenging due to nonspecific symptoms and serologic cross-reactivity among flaviviruses, complicating etiological identification.
Case Report (n=1)
No
Severe dengue infection can lead to fulminant myocarditis and cardiogenic shock requiring extensive mechanical circulatory support, but patients can still achieve full cardiac recovery.
MCS may enable recovery in dengue myocarditis shock; case report leaves open questions on generalizability and selection criteria.
BACKGROUND: Dengue is a viral zoonotic disease found in tropical and subtropical countries and transmitted by arthropod vectors, primarily Aedes mosquitoes. Dengue manifestations vary, and reinfection can trigger severe disease, including myocarditis. Nonspecific symptoms and serologic cross-reactivity among flaviviruses make etiological diagnosis difficult. CASE SUMMARY: A 21-year-old otherwise healthy woman presented with fever and cardiogenic shock requiring mechanical circulatory support after returning from Brazil. Dengue virus (DENV) serotype-2 antibodies were found, with evidence of prior DENV serotype-1 infection. The patient was treated supportively and eventually recovered full cardiac function. DISCUSSION: Dengue is one of the fastest growing mosquito-borne illnesses globally and is caused by 1 of 4 virus serotypes. There is no specific treatment for the infection, and flavivirus antibody assays are highly cross-reactive, requiring plaque reduction neutralization assays or other specialized tests to differentiate flavivirus infections. TAKE-HOME MESSAGE: Dengue shock syndrome with myocarditis may require mechanical circulatory support but carries a good prognosis for recovery.
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Slajus et al. (2026) conducted a case report in Fulminant dengue myocarditis with cardiogenic shock (n=1). Mechanical circulatory support (ECMO and Impella) was evaluated on Cardiac recovery. Mechanical circulatory support enabled full cardiac recovery in a 21-year-old woman presenting with cardiogenic shock from fulminant dengue myocarditis.
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