Interstitial and Coxsackievirus B Myocarditis in Infants and Children

Fifty hearts of infants and children were collected at routine autopsies and were surveyed by means of routine histologic techniques and immunofluorescent antibody staining methods. Twenty-nine hearts had interstitial myocarditis with varying degree of myocardial damage. Seventeen had interstitial reactions with an increase in cellularity and with patchy edema. Coxsackievirus B antigens were found in 12 of these hearts. The high incidence of coxsackievirus B antigen in the myocardium of the infants and children is possibly related to the "myocarditis," labeled variously as Fiedler's, idiopathic, interstitial, isolated, or aseptic myocarditis or chronic rheumatic heart disease. The common occurrence of clinically occult coxsackievirus B infection may possibly be related to the etiology of still-births, congenital anomalies, and sudden, unexpected deaths in infancy and childhood. The need for better diagnostic virological facilities in clinical practice is evident from these studies.