Virchows Archiv

, Volume 458, Issue 3, pp 371–376

Sudden death of an immunocompetent young adult caused by novel (swine origin) influenza A/H1N1-associated myocarditis

  • Georg Gdynia
  • Paul Schnitzler
  • Eva Brunner
  • Reinhard Kandolf
  • Hendrik Bläker
  • Edith Daum
  • Philipp Schnabel
  • Peter Schirmacher
  • Wilfried Roth
Case Report

DOI: 10.1007/s00428-010-1035-0

Cite this article as:
Gdynia, G., Schnitzler, P., Brunner, E. et al. Virchows Arch (2011) 458: 371. doi:10.1007/s00428-010-1035-0

Abstract

The main cause of death from novel (swine origin) influenza A/H1N1 infection is acute respiratory distress syndrome. Most fatal cases are immunocompromised patients or patients with a severe underlying disease. Here, we report a fatal case of acute interstitial myocarditis associated with novel influenza A/H1N1 infection in an immunocompetent young woman. A previously healthy 18-year-old woman experienced malaise, diarrhea, and fever for several days prior to a sudden collapse at home. Autopsy revealed a predominantly lymphocytic myocarditis in the absence of a significant respiratory tract infection. Infection with novel (swine origin) influenza A/H1N1 was confirmed by PCR analysis of blood as well as myocardial tissue. Influenza-caused diarrhea with consecutive hypokalemia potentially contributed to the fatal outcome of the myocarditis, characterized by ventricular fibrillation. In conclusion, sudden death by myocarditis may be a rare complication of novel influenza A/H1N1 infection in otherwise healthy individuals, even in the absence of significant respiratory tract infection.

Keywords

Novel influenza ASwine fluH1N1Myocarditis

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Georg Gdynia
    • 1
  • Paul Schnitzler
    • 2
  • Eva Brunner
    • 3
  • Reinhard Kandolf
    • 3
  • Hendrik Bläker
    • 1
  • Edith Daum
    • 2
  • Philipp Schnabel
    • 1
  • Peter Schirmacher
    • 1
  • Wilfried Roth
    • 1
  1. 1.Institute of PathologyUniversity HospitalHeidelbergGermany
  2. 2.Department of Infectious Diseases, VirologyUniversity HospitalHeidelbergGermany
  3. 3.Department of Molecular PathologyUniversity HospitalTübingenGermany