Serious Coxsackie Infection in Infants and Children: Myocarditis, Meningoencephalitis, and Hepatitis

Coxsackie viruses are considered to be among the most prevalent of recognized viruses. They are known to cause herpangina, epidemic pleurodynia, and aseptic meningitis, but until recently they have not been thought to cause death. To date, five reports have described fatal myocarditis in newborn infants caused by Type B-3 or B-4 Coxsackie virus. 1-5 Four of these reports originated abroad, in South Africa, and described epidemics of fatal myocarditis occurring in newborn infants during epidemics of pleurodynia or aseptic meningitis or both in the population at large. We are reporting the isolation, during a nonepidemic period, of a Coxsackie Group B Type 4 virus at autopsy from the myocardium of a 7-week-old infant who died in heart failure and from the myocardium, liver, lung, and kidney of a 14-day-old infant who died of sepsis of unknown cause. A 5-year-old boy recovered completely from myocarditis during which Group B Type