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Published on: May 24, 2016
Infantile intracardiac thrombus in severe encephalo-myocarditis
S Woodhull1, K K Choo2, S D Terumalay2
1Subang Jaya Medical Centre, Department of Paediatrics, Malaysia. dr.sanjay.woodhull@rsdhealth.com, swoodhull@gmail.com.
Insights
Fulminant viral myocarditis in a child, complicated by intracardiac thrombus, led to multi-organ failure. Successful medical management highlights the need for high suspicion and defined treatment strategies for this rare pediatric condition.
Area of Science:
- Pediatric Cardiology
- Infectious Diseases
- Critical Care Medicine
Background:
- Myocarditis is an uncommon pediatric disease with varied presentations, demanding high clinical suspicion.
- Intracardiac thrombus formation secondary to myocarditis is a rare complication with undefined management protocols.
Purpose of the Study:
- To report a case of fulminant viral myocarditis with encephalitis and intracardiac thrombus in a child.
- To describe the challenges in managing this rare complication and propose treatment guidance.
Main Methods:
- Case report of a pediatric patient with viral prodrome, multi-organ failure, and subsequent myocarditis and encephalitis.
- Detailed description of the diagnostic and therapeutic interventions employed.
Main Results:
- The patient presented with rapid deterioration, fulminant viral myocarditis, encephalitis, and intracardiac thrombus formation.
- Successful medical treatment was achieved, despite the complexity of the presentation.
Conclusions:
- Fulminant viral myocarditis with intracardiac thrombus is a severe pediatric condition requiring prompt recognition.
- This case underscores the importance of a high index of suspicion and suggests factors for guiding treatment in similar complex pediatric cases.
Abstract:
Myocarditis is an uncommon disease in childhood and has a wide range of clinical presentations, from subtle to devastating and thus requires a high index of suspicion. Intracardiac thrombus formation following myocarditis is rare and thus its management remains challenging and not well defined. We report a child whom presented with a viral prodrome, rapidly deteriorated into multi organ failure and developed fulminant viral myocarditis with encephalitis that was complicated with an intracardiac thrombus formation. We describe the challenges faced, the successful medical treatment offered and propose factors that can help guide appropriate treatment.
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