Fatal intrauterine adenoviral endomyocarditis with aortic and pulmonary valve stenosis: Diagnosis by polymerase chain reaction

We report a case of fatal hydrops fetalis owing to adenoviral endomyocardit is with aortic and pulmonary valve stenosis. A 1850-g macerated male stillb orn delivered 1 week after fetal ultrasonography showed hydrops, cardiomega ly, and possible aortic valve stenosis. Autopsy confirmed hydrops and showe d thickened, fibrotic semilunar valves with stenosis. The myocardium was fo cally fibrotic with areas of calcification. Polymerase chain reaction study of myocardial and aortic valve tissue was positive for adenovirus. Intraut erine viral myocarditis has been reported only rarely, but cases owing to C oxsackie B virus, adenovirus, and parvovirus B19 have appeared in the liter ature. With the exception of rubella, viral causation of significant valvul ar lesions in humans has received scanty support in the literature. This re port suggests a broader group of causative agents. HUM PATHOL 31:1433-1435. Copyright (C) 2000 by W.B. Saunders Company.