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Fulminant parvovirus B19 myocarditis in infants -report of three post-pandemic cases

Tatjana Wahjudi1, Alex Nitsch2, Jan-Peter Sperhake3

  • 1Department of Paediatrics, Catholic Children´s Hospital Wilhelmstift, Liliencronstr 130, 22149, Hamburg, Germany.

European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology
|February 17, 2025
PubMed

Insights

A rise in parvovirus B19 (PVB19) infections has caused severe myocarditis in infants. This study highlights three infant cases of fulminant PVB19 myocarditis, suggesting a potential link to pandemic-related "immune debt".

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Cardiology

Background:

  • The COVID-19 pandemic has led to reduced immune stimulation, termed "immune debt."
  • This has resulted in a resurgence of common pediatric infectious diseases.
  • Parvovirus B19 (PVB19) is one such pathogen now re-emerging.

Purpose of the Study:

  • To report on three cases of fulminant parvovirus B19 myocarditis in infants.
  • To highlight the potential increased risk of severe myocarditis in infants due to PVB19.
  • To explore the possible association between PVB19 myocarditis and pandemic-induced immune debt.

Main Methods:

  • Case series observation of three infant patients.
  • Clinical assessment including presentation, prodromal illness, and outcome.
  • Analysis of clinical course and cause of death.

Main Results:

  • Three infants presented with fulminant parvovirus B19 myocarditis.
  • All cases experienced a brief prodromal illness.
  • All infants succumbed to cardiogenic shock within 2 to 72 hours of admission.

Conclusions:

  • Fulminant myocarditis due to parvovirus B19 appears to pose a significant risk to infants.
  • The incidence of PVB19-associated fulminant myocarditis may be increasing.
  • Further research is warranted to confirm the link between "immune debt" and PVB19 myocarditis incidence.

Keywords:
FulminantMyocarditisParvovirus B19 virus“immune debt”

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