AN AUTOPSY CASE OF PROTRACTED GRANULOMATOUS MYOCARDITIS AFTER CYTOMEGALO-VIRAL INFECTION

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  • サイトメガロウイルス感染に続発した肉芽腫性心筋炎の一剖検例

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A 25-year-old male was admitted to the hospital complaining of epiabdominal pain, vomitting and palpitation for one month after a common cold. Chest X-ray and ultrasonography (US) examination revealed cardiomegaly with pericardial and pleural effusion. Electrocardiogram examination revealed frequent PVC, and laboratory data showed the high antibody titer of cytomegalovirus. In spite of symptomatic therapy, severe cardiomegaly on US developed dilated cardiomyopathy (DCM) on the 3rd hospital day. Cardiac disfunction persisted and he expired in the about 3rd hospital month. Autopsy revealed severe dilated cardiomegaly and, microscopically, diffuse fibrosis with massive granulomatous foci, chiefly on the endocardial side, of the heart. Pathomorphological study suggested that granulomatous myocarditis after cytomegalo-viral infection developed into DCM like lesion, but viral infection was not proved pathologically.

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