Veno-arterial extracorporeal membrane oxygenation for severe fever with thrombocytopenia syndrome with fulminant myocarditis: a case report

BMC Infectious Diseases

Kye Hun Kim¹  Hyukjin Park¹  Uh. Jin Kim²  Seung Ji Kang²  Sook In Jung²  Seung Eun Kim²  Kyung-Hwa Park²  Dong Min Kim³ 

[1] Department of Cardiology, Chonnam National University Hospital, Gwangju, Republic of Korea;Department of Infectious Diseases, Chonnam National University Medical School, 42 Jaebongro, Dong-gu, 61469, Gwangju, South Korea;Division of infectious Diseases, Department of Internal Medicine, Chosun University College of Medicine, Gwangju, Republic of Korea;

关键词: SFTS;    Myocarditis;    ECMO;    Case report;   

DOI  :  10.1186/s12879-021-06446-4

来源: Springer

【 摘 要 】

BackgroundThe clinical spectrum of severe fever with thrombocytopenia syndrome (SFTS) is wide, which can range from fever to multiple organ failure. Conservative therapy plays a key role in the treatment of SFTS. However, severe cases of SFTS, such as fulminant myocarditis, may require mechanical hemodynamic support.Case presentationThis report presents a case of a 59-year old woman diagnosed with SFTS by reverse-transcription polymerase chain reaction. The patient had no initial symptoms of cardiac involvement and rapidly developed hemodynamic instability 3 days after hospitalization. She suffered from chest pain and had elevated cardiac enzymes. In the absence of atrio-ventricular conduction abnormalities, left ventricular dysfunction, and coronary artery abnormalities by coronary angiography, she was diagnosed with fulminant myocarditis. At that time, her pulse rate nearly dropped to 0 bpm and she developed near complete akinesia of the heart despite vasopressor administration. Veno-arterial extracorporeal membrane oxygenation (ECMO) was initiated with other supportive measures and she fully recovered after 21 days.ConclusionsThis case indicates that SFTS can cause fulminant myocarditis even without evidence of cardiac involvement at presentation. When symptoms and/or signs of acute heart failure develop in patients with SFTS, myocarditis should be suspected and the patient should be promptly evaluated. Additionally, mechanical hemodynamic support like ECMO can be a lifesaving tool in the treatment of fulminant myocarditis.

【 授权许可】

CC BY