DOI: 10.12890/2023_003759
Cardiogenic shock associated with acute norovirus gastroenteritis: what is needed to prove causality?
Authors
mahmoud.hassan.abdelnabi@outlook.com
Keywords
Myocarditis, gastroenteritis, enteric viruses, norovirusAbstract
Acute myocarditis is a well-recognized condition attributable to a variety of viral illnesses. Common viral aetiologies include enteroviruses including coxsackie, adenovirus, influenza, echovirus, parvovirus B19 and herpesvirus. A high index of suspicion, early diagnosis, and prompt management with supportive anti-failure measures, and in selected cases immunosuppressive therapies including high-dose steroids, might be considered for better outcomes. The authors report a case of sudden onset of acute heart failure complicated by cardiogenic shock caused by viral myocarditis in a patient who initially presented with norovirus gastroenteritis. She had no previous cardiac history or significant cardiovascular risk factors. Prompt medical management for cardiogenic shock for norovirus-induced myocarditis was started, her symptoms gradually improved, and she was discharged safely on regular follow-up.
References
- Schultheiss HP, Baumeier C, Aleshcheva G, Bock CT, Escher F. Viral myocarditis—from pathophysiology to treatment. J Clin Med 2021;10:5240.
- Robilotti E, Deresinski S, Pinsky BA. Norovirus. Clin Microbiol Rev 2015;28:134–164.
- Petrignani M, Verhoef L, de Graaf M, Richardus JH, Koopmans M. Chronic sequelae and severe complications of norovirus infection: a systematic review of literature. J Clin Virol 2018;105:1–10.
- Ammirati E, Frigerio M, Adler ED, Basso C, Birnie DH, Brambatti M, et al. Management of acute myocarditis and chronic inflammatory cardiomyopathy: an expert consensus document. Circ Heart Fail 2020;13:e007405.
- Huang P, Farkas T, Zhong W, Tan M, Thornton S, Morrow AL, et al. Norovirus and histo-blood group antigens: demonstration of a wide spectrum of strain specificities and classification of two major binding groups among multiple binding patterns. J Virol 2005;79:6714–6722.
- Pringle K, Lopman B, Vega E, Vinje J, Parashar UD, Hall AJ. Noroviruses: epidemiology, immunity and prospects for prevention. Future Microbiol 2015;10:53–67.
- Caforio AL, Pankuweit S, Arbustini E, Basso C, Gimeno-Blanes J, Felix SB, et al. Current state of knowledge on aetiology, diagnosis, management, and therapy of myocarditis: a position statement of the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases. Eur Heart J 2013;34:2636–2648.
- Piret J, Boivin G. Viral interference between respiratory viruses. Emerg Infect Dis 2022;28:273.
- Berger AK, Mainou BA. Interactions between enteric bacteria and eukaryotic viruses impact the outcome of infection. Viruses 2018;10:19.