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Acute fulminant myoglobinuric polymyositis with picornavirus-like crystals

Insights

An 11-month-old girl experienced fever, dyspnea, and hypotonia, leading to the discovery of myoglobinuria. Picornavirus-like crystals in muscle fibers suggest Coxsackie B6 virus caused acute myositis.

Area of Science:

  • Virology
  • Neurology
  • Pediatrics

Background:

  • Viral infections can manifest with diverse neurological and muscular symptoms.
  • Myositis, inflammation of muscles, can lead to significant morbidity in children.
  • Myoglobinuria, the presence of myoglobin in urine, indicates muscle damage.

Observation:

  • An infant presented with fever, dyspnea, and muscle hypotonia.
  • Muscle biopsy revealed focal degenerative necrosis of muscle fibers.
  • Electron microscopy identified picornavirus-like crystals within muscle fibers.

Findings:

  • The clinical presentation and biopsy findings strongly suggest acute myositis.
  • The presence of picornavirus-like crystals points to a viral etiology, likely Coxsackie B6 virus.
  • Myoglobinuria was a key indicator of the muscle damage.

Implications:

  • This case highlights Coxsackie B6 virus as a potential cause of acute myositis and myoglobinuria in infants.
  • Understanding the link between viral infections and myositis is crucial for timely diagnosis and management.
  • Further research into viral polymyositis is warranted to explore acute and chronic forms.

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