Human parvovirus B19 infection in infancy associated with acute and chronic lymphocytic myocarditis and high cytokine levels: Report of 3 cases and review

Human parvovirus B19 infection is occasionally associated with acute lympho cytic myocarditis (ALM), Three infants with B19 virus-associated ALM were f ollowed up clinically, histologically, and immunovirologically. Each infant had B19 virus DNA in the blood or B19 virus-specific IgM antibodies, Two i nfants with postnatal infection recovered after immunosuppressive therapy. The third infant with possible prenatal infection developed chronic persist ent myocarditis associated with persistent B19 virus DNA in the blood. All 3 infants had increased levels of interferon-gamma, tumor necrosis factor-a lpha, and interleukins -6 and -8, Four newborns with congenital B19 virus i nfection and 3 infants and children who had postnatally acquired B19 virus infection without myocarditis all had normal levels of these cytokines. The se observations suggest that B19 virus infection in infancy causes ALM in s ome infants and children.