Coxsackie B viral infection presenting with hemorrhagic pericardial effusion and pleural effusion

Area of Science:

• Pediatric Cardiology
• Infectious Diseases
• Critical Care Medicine

Background:

• Acute myopericarditis can present with life-threatening complications in children.
• Coxsackie B virus is a common cause of viral myocarditis and pericarditis.
• Hemorrhagic pericardial and pleural effusions are rare but serious manifestations.

Observation:

• An 11-year-old female presented with cough, shortness of breath, and chest pain.
• She exhibited signs of cardiac tamponade due to hemorrhagic pericardial effusion and moderate left ventricular dysfunction.
• Massive bilateral hemorrhagic pleural effusions were also noted.

Findings:

• The patient screened positive for Coxsackie B infection.
• Emergency pericardiocentesis was required for cardiac tamponade relief.
• Bilateral chest drains were placed for massive pleural effusions.

Implications:

• This case underscores the potential severity of Coxsackie B virus-induced myopericarditis in pediatric patients.
• Early recognition and intervention, including pericardiocentesis and chest tube drainage, are crucial for managing tamponade and effusions.
• Steroids and ibuprofen, alongside supportive care, facilitated a complete recovery, suggesting their role in managing pediatric myopericarditis.