• 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.

    • Search Google Scholar
    • Export Citation
  • 3.

    Gulati S, Maheshwari A, 2007. Atypical manifestations of dengue. Trop Med Int Health 12: 10871095.

  • 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.

  • 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.

    • Search Google Scholar
    • Export Citation
  • 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.

    • Search Google Scholar
    • Export Citation
  • 7.

    Lee CH, Teo C, Low AF, 2009. Fulminant dengue myocarditis masquerading as acute myocardial infarction. Int J Cardiol 136: e69e71.

  • 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.

    • Search Google Scholar
    • Export Citation
  • 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.

    • Search Google Scholar
    • Export Citation
  • 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.

    • Search Google Scholar
    • Export Citation
  • 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.

    • Search Google Scholar
    • Export Citation
  • 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.

    • Search Google Scholar
    • Export Citation
  • 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.

    • Search Google Scholar
    • Export Citation
  • 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.

    • Search Google Scholar
    • Export Citation
 
 
 

 

 
 
 

 

 

 

 

 

 

Myocarditis in a Traveler Returning from the Dominican Republic: An Unusual Presentation of Dengue Fever

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  • Division of Infectious Diseases, Maimonides Medical Center, Brooklyn, New York; Department of Medicine, Lutheran Medical Center, Brooklyn, New York

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.

Author Notes

* Address correspondence to Diego Zea, 4719 Fort Hamilton Parkway, New York, NY 11219. E-mail: dzepif@gmail.com

Authors' addresses: Diego Zea, Division of Infectious Diseases, Maimonides Medical Center, Brooklyn, NY, E-mail: dzepif@gmail.com. Kimberly Foley and Jeanne Carey, Department of Medicine, Lutheran Medical Center, Brooklyn, NY, E-mails: kimfoley87@gmail.com and jcarey@lmcmc.com.

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