Korean J Leg Med.  2015 Aug;39(3):73-77. 10.7580/kjlm.2015.39.3.73.

A Case of Concurrent Acute Viral Myocarditis and Intussusceptions in a 3-Year-Old Child

• Maeng YI
• Kim YH
• Lee HY
• Kim JM

• KMID: 2044952
• DOI: http://doi.org/10.7580/kjlm.2015.39.3.73

Abstract

Chickenpox is an acute disease caused by the varicella-zoster virus (VZV), a herpesvirus that causes human infection worldwide. Primary VZV infection routinely occurs during childhood and is usually a self-limiting illness in immunocompetent children. However, chickenpox can be a severe disease in adolescents, adults, and immunosuppressed or immunocompromised patients. Although vaccination substantially attenuates disease manifestations, significant complications such as secondary soft tissue infection, encephalitis, and pneumonia can occur. We present a rare autopsy case of concurrent acute myocarditis and intussusceptions in a 3-year-old female child who presented with chickenpox followed by abdominal pain and sudden death. The present case emphasizes the potential for fatal complications of viral infections, which should be considered in cases of sudden unexpected infectious death in children.

Keyword

Chickenpox; Intussusception; Myocarditis; Sudden death; Viral disease

MeSH Terms

Abdominal Pain
Acute Disease
Adolescent
Adult
Autopsy
Chickenpox
Child*
Child, Preschool*
Death, Sudden
Encephalitis
Female
Herpesvirus 3, Human
Humans
Immunocompromised Host
Intussusception*
Myocarditis*
Pneumonia
Soft Tissue Infections
Vaccination
Virus Diseases

Figure

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  Fig. 1. Gross autopsy findings of the heart (A) with multiple areas of gray-whitish lesions on the cut surface after formalin fixation (B).

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  Fig. 2. (A) Microscopic findings of inflammatory infiltration of the myocardium. The infiltrates are mostly lymphocytes (H&E, ×400). Immunohistochemical staining of inflammatory cells with CD3 (B) and CD20 (C) (×400).

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  Fig. 3. Gross autopsy findings of three areas of intestinal intussusceptions in the small intestine without visible peritonitis (A), and one of the opened intussusceptions (lesions are indicated by arrows) (B).

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