Myocarditis: an uncommon manifestation of dengue fever infection

Abstract

A 30-year-old man with a history of non-Hodgkin's lymphoma presented with oppressive chest pain radiating to the left arm. ECG revealed sinus rhythm (60 bpm), and non-specific T wave changes in leads DI and DII, without ST-segment elevation; troponin I level was elevated: 6.39 ng/mL (normal value <0.120 ng/mL). Echocardiography showed left ventricle ejection fraction of 58%, no systolic or diastolic disturbances, valve abnormalities or other lesions. He was referred to our institution with a suspicion of a non-ST segment elevation myocardial infarction. Due to this unusual diagnosis at his age, other causes of chest pain were ruled out. In a new interview, the patient indicated that he had had fever and diffuse myalgias after a trip to an endemic dengue region 2 weeks before. Thus, dengue-specific antibodies were ordered, which disclosed reactive IgM, negative IgG and negative non-structural protein 1.