Volume 91, Issue 1
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



Myocarditis is an uncommon manifestation of dengue fever. We describe a case of a 69-year-old Hispanic male who presented to an emergency room in New York City 3 days after returning from a trip to the Dominican Republic complaining of a 1-day history of chest pain and fever. His first electrocardiogram showed a new left bundle branch block, and initial cardiac enzymes included troponin of 5 ng/dL, creatine kinase-MB of 9 ng/mL, and myoglobin of 234 ng/mL. Dengue fever antibodies were found to be elevated: immunoglobulin M (IgM) titer was 2.48 (reference range < 0.9), and immunoglobulin G (IgG) titer was 4.26 (reference range < 0.9). The patient was diagnosed with myocarditis caused by dengue fever. He improved after 1 week with conservative management in a telemetry unit and was discharged home.


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  1. WHO, 2009. Dengue, Guidelines for Diagnosis, Treatment, Prevention and Control—New Edition. Geneva: World Health Organization.
  2. Srikiatkhachorn A, Rothman AL, Gibbons RV, Sittisombut N, Malasit P, Ennis FA, Nimmannitya S, Kalayanarooj S, , 2011. Dengue—how best to classify it. Clin Infect Dis 53: 563567.[Crossref]
  3. Gulati S, Maheshwari A, , 2007. Atypical manifestations of dengue. Trop Med Int Health 12: 10871095.[Crossref]
  4. Nagaratnam N, Siripala K, de Silva N, , 1973. Arbovirus (dengue type) as a cause of acute myocarditis and pericarditis. Br Heart J 35: 204206.[Crossref]
  5. Kularatne SA, Pathirage MM, Medagama UA, Gunasena S, Gunasekara MB, , 2006. Myocarditis in three patients with dengue type 3 infection. Ceylon Med J 51: 7576.
  6. Lee IK, Lee WH, Liu JW, Yang KD, , 2010. Acute myocarditis in dengue hemorrhagic fever: a case report and a review of cardiac complications in dengue-affected patients. Int J Infect Dis 14: e919e922.[Crossref]
  7. Lee CH, Teo C, Low AF, , 2009. Fulminant dengue myocarditis masquerading as acute myocardial infarction. Int J Cardiol 136: e69e71.[Crossref]
  8. Salgado DM, Eltit JM, Mansfield K, Panqueba C, Castro D, Vega MR, Xhaja K, Schmidt D, Martin KJ, Allen PD, Rodriguez JA, Dinsmore JH, Lopez JR, Bosch I, , 2010. Heart and skeletal muscle are targets of dengue virus infection. Pediatr Infect Dis J 29: 238242.[Crossref]
  9. Premaratna R, Rodrigo KM, Anuratha A, de Alwis VK, Perera UD, de Silva HJ, , 2012. Repeated dengue shock syndrome and ‘dengue myocarditis’ responding dramatically to a single dose of methyl prednisolone. Int J Infect Dis 16: e565e569.[Crossref]
  10. Srichaikul T, Punyagupta S, Sorakhunpipitkul L, Udomsubpayakul U, , 2011. Adjunctive corticosteroid therapy in 149 grade II (non-shock) adult DHF patients: an analysis during January 2008–February 2010. J Med Assoc Thai 94: 14191423.
  11. Tricou V, Minh NN, Van TP, , 2010. A randomized controlled trial of chloroquine for the treatment of dengue in Vietnamese adults. PLoS Negl Trop Dis 4: e785.[Crossref]
  12. Centers for Disease Control and Prevention, 2012. How to Reduce Your Risk of Dengue Infection. Available at: http://www.cdc.gov/dengue/prevention/index.html. Accessed June 17, 2012.
  13. Halstead SB, , 2013. Dengue: the syndromic basis to pathogenesis research. Inutility of the 2009 WHO case definition. Am J Trop Med Hyg 88: 212215.[Crossref]
  14. Chaterji S, Allen JC, Jr Chow A, Leo Y-S, Ooi E-E, , 2011. Evaluation of the NS1 rapid test and the WHO dengue classification schemes for use as bedside diagnosis of acute dengue fever in adults. Am J Trop Med Hyg 84: 224228.[Crossref]

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  • Received : 01 Nov 2013
  • Accepted : 14 Feb 2014

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