Coxsackie B virus in children with acute myocarditis

PURPOSE: To study etiopathogenic and follow-up aspects of patients with myocarditis. PATIENTS AND METHODS: Among 44 cases of acute myocarditis in children studied from clinical and virological point of view, it was selected 16 which were positive to coxsackie B virus. The clinical investigation included blood test to enzyme dosage, chest X-ray, electro and echocardiogram. The virological work up to coxsackie B1, B3, B4, B5 and B6 included culture neutralization test and IgM (indirect immunofluorescence). RESULTS: The positive results were: B4 in 9 (57%); B5 in 4 (25%), B1 in 2 (12%) and B3 in 1 (6%). It was not used immunosuppressive treatment. The follow-up (at least one year it was: 7 patients became free of symptoms (43%); 4 (25%) turned to be chronic dilated myocardiopathy 1 (6%) died and 4 (25%) were discharged from hospital but did not return to out-patient clinic. One of patients of chronic group during 4 years of follow-up had ventricular extrasystoles, second degree heart block and now is asymptomatic. CONCLUSION: We did not observe significative differences among the several types of coxsackie B related to clinical course.