Myopericarditis associated with varicella zoster virus infection

Acute myopericarditis is a major cause of acquired heart disease worldwide in pediatric patients. Various viruses have been reported as the etiology, of which varicella zoster virus was first reported in 1953. However, since nationwide administration of the varicella vaccine, reports of varicella-associated myopericaridits have become sporadic. We report a case of varicella myopericarditis with an initial manifestation of chest pain, tachycardia, and hypotension. Typical skin vesicles developed 2 days after these symptoms, which confirmed the diagnosis. Intravenous immunoglobulin was administered before the appearance of the skin vesicles under the impression of suspected Coxsackie virus infection. Intravenous acyclovir effectively controlled the progression of the disease, and both clinical symptoms and electrocardiographic changes subsided soon after the use of an antiviral agent. Varicella zoster virus serum IgM antibody also showed positive test results. On the following visit, the patient's myocardial function had fully recovered from this episode.