Objective: To determine whether enterovirus RNA can be demonstrated in archival necropsy material in acute myocarditis.
Design: Analysis of paraffin embedded myocardial tissue from cases of acute myocarditis.
Setting: University virology department.
Methods: Extraction of RNA from tissue followed by polymerase chain reaction (PCR) and DNA sequence analysis.
Patients: Six patients with histologically proven myocarditis and eight controls.
Results: Enterovirus RNA was identified in 5 of 6 patients with myocarditis and in none of the controls. The nucleotide sequences of the PCR products showed greatest similarity to group B coxsackieviruses, particularly coxsackievirus B3.
Conclusion: This study indicates that archival tissue samples, even histologically stained tissue sections, can be used to study the role of enteroviruses in myocardial disease using molecular detection techniques. If a predominant role for coxsackievirus B3 in myocarditis is confirmed by further study, this may have implications for the development of a specific vaccine.