Myopericarditis Manifestation in Post-Dengue Infection Pediatric Patient in Endemic Country: Case Report

Background: Myopericarditis is one of the serious complications of severe dengue manifestations. The increased risk of myopericarditis in severe dengue cases may be associated with the immune system’s overactivity. Dengue myocarditis has a higher prevalence in the pediatric population than in adults. Case Illustration: An 11-year-old boy presented with heart failure syndrome after a recent dengue fever infection. Laboratory test results showed increased Erythrocyte Sedimentation Rate (ESR) and serum Lactate dehydrogenase (LDH), with a slight increase of serum troponin. Echocardiography and Cardiac Magnetic Resonance (CMR) studies confirm myocardial and pericardial involvement. Post-dengue myopericarditis diagnosis was made, and the patient was administered anti-heart failure medication and oral corticosteroid therapy. The patient improved after one month of therapy, as shown by the evaluation of laboratory and imaging criteria. Conclusions: Myocarditis should be considered if one of the classic triad of myocarditis, such as chest pain, congestive heart failure, and/or arrhythmia, develops in a recent viral infection history. These phenomena suggest that the clinician consider and have a high index of suspicion toward latent complications of post-dengue myocardial and pericardial inflammation syndrome. Hence, early diagnosis and long-term longitudinal surveillance studies are of the utmost importance in dengue-induced myopericarditis, especially in the dengue-endemic area, in order to prevent myocardial remodeling progression to dilated cardiomyopathy.