ENTEROVIRUSES AS A POSSIBLE CAUSE OF MYOCARDITIS, PERICARDITIS AND DILATED CARDIOMYOPATHY IN BELEM, BRAZIL

We attempted to assess the role of enteroviruses in the etiology of my ocarditis (MC), pericarditis (PC) and dilated cardiomyopathy (DCM) amo ng 15 in-patients at a public hospital in Belem, Brazil, from November 1992 to December 1993. We obtained stool specimens and throat swabs f rom each patient (particularly acute cases) and, when possible, acute and convalescent serum samples for both isolation and serological proc edures. MC, PC and DCM occurred in 10, 2 and 3 patients, respectively, mostly in the 0- to 10-year age group. Neutralizing antibody seroconv ersions were detected as follows: one for Coxsackievirus (Cox) B2 in o ne patient suffering from MC, and two for Cox B4, in patients with DCM and MC. In addition, antibody titers of 1/320 against Cox B2 and Cox B4 were noted in two other patients, one suffering from PC and the oth er presenting MC. Isolation of echovirus (ECHO) serotype 1 was recorde d in a patient with MC, without either seroconversion or high antibody levels for Cox B 1 to 6. These results indicate that enteroviruses ma y be involved in the etiology of MC, PC and DCM in the Amazon region.