Influenza B virus infection complicated by life-threatening pericarditis: a unique case-report and literature review

BMC Infect Dis. 2019 Jan 10;19(1):40. doi: 10.1186/s12879-018-3606-7.

Abstract

Background: Acute pericarditis may occur frequently after viral infections. To our knowledge, influenza B virus infection complicated by pericarditis without myocardial involvement has never been reported. We report the first case of life-threatening pericarditis caused by influenza B virus infection.

Case presentation: A 48-years-old woman with trisomy 21 and ostium primum atrial septal defect was transferred from Cardiology to our Internal Medicine Department for severe pericardial effusion unresponsive to ibuprofen and colchicine. Based on the recent patient history of flu-like syndrome, and presence of pleuro-pericardial effusion, a viral etiology was suspected. Laboratory evaluation and molecular assay of tracheal aspirate identified influenza B virus. Therefore, the ongoing metilprednisolone and colchicine therapy was implemented with oseltamivir with progressive patient improvement and no evidence of pericardial effusion recurrence during follow-up.

Conclusions: Especially in autumn and winter periods, clinicians should include Influenza B virus infection on differential diagnosis of pericarditis with large pericardial effusion.

Keywords: Congenital heart disease with pulmonary hyper flow; Down syndrome; Pericardial effusion; Pericarditis; Type B influenza virus; Vaccination.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Antiviral Agents / therapeutic use*
  • Female
  • Humans
  • Ibuprofen / therapeutic use
  • Influenza B virus / pathogenicity
  • Influenza, Human / complications*
  • Influenza, Human / drug therapy*
  • Influenza, Human / virology
  • Methylprednisolone / therapeutic use
  • Middle Aged
  • Oseltamivir / therapeutic use
  • Pericardial Effusion / diagnostic imaging
  • Pericardial Effusion / virology
  • Pericarditis / diagnosis
  • Pericarditis / drug therapy*
  • Pericarditis / virology*

Substances

  • Antiviral Agents
  • Oseltamivir
  • Ibuprofen
  • Methylprednisolone