Myocarditis in a traveler returning from the Dominican Republic: an unusual presentation of dengue fever

Am J Trop Med Hyg. 2014 Jul;91(1):156-8. doi: 10.4269/ajtmh.13-0637. Epub 2014 Jun 2.

Abstract

Myocarditis is an uncommon manifestation of dengue fever. We describe a case of a 69-year-old Hispanic male who presented to an emergency room in New York City 3 days after returning from a trip to the Dominican Republic complaining of a 1-day history of chest pain and fever. His first electrocardiogram showed a new left bundle branch block, and initial cardiac enzymes included troponin of 5 ng/dL, creatine kinase-MB of 9 ng/mL, and myoglobin of 234 ng/mL. Dengue fever antibodies were found to be elevated: immunoglobulin M (IgM) titer was 2.48 (reference range < 0.9), and immunoglobulin G (IgG) titer was 4.26 (reference range < 0.9). The patient was diagnosed with myocarditis caused by dengue fever. He improved after 1 week with conservative management in a telemetry unit and was discharged home.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antibodies, Viral / blood*
  • Creatine Kinase / blood
  • Dengue / complications
  • Dengue / immunology
  • Dengue / pathology*
  • Dengue / virology
  • Dengue Virus*
  • Dominican Republic
  • Humans
  • Male
  • Myocarditis / complications
  • Myocarditis / immunology
  • Myocarditis / pathology*
  • Myocarditis / virology
  • Myoglobin / blood
  • Travel
  • Troponin / blood

Substances

  • Antibodies, Viral
  • Myoglobin
  • Troponin
  • Creatine Kinase