Epstein-Barr virus: an unusual cause of severe acute viral myocarditis in children.

Epstein-Barr virus does not belong to the principal causative agents of acu te myocarditis, whose diagnosis and pathogenesis are often difficult to det ermine. Treatment is also controversial regarding the use of anti-inflammat ory or immunosuppressive therapy. Case report - We describe a 13-month-old girl, admitted for acute heart fai lure, in whom cardiac catheterization with endomyocardial biopsy revealed a n acute myocarditis. Acute viral titers indicated infectious mononucleosis caused by Epstein-Barr virus, and the virus genome was identified with a po lymerase chain reaction in the patient's serum. The patient had clinical im provement after corticosteroid administration. Conclusion. - The different diagnostic tools and the screening examinations to determine the causative agent of myocarditis are discussed. The frequen cy of Epstein-Barr virus in pathogenesis is also considered. The favorable outcome with immunosuppressive therapy suggests its administration in cases of acute myocarditis. (C) 2000 Editions scientifiques et medicales Elsevie r SAS.