There are few reports of varicella-zoster myocardial involvement. Hackel1 found focal inflammatory, often perivascular lesions and occasional myocardial fiber necrosis in six children and one adult; no inclusion bodies were seen. Epicarditis was often present. He suggested that such lesions might lead to focal, myocardial fibrosis. Sampson2 described perivascular lymphocytic infiltration and fibrinoid swelling as well as degeneration and necrosis of muscle fibers in a child. A recent report3 concerns acute varicellous myocarditis superimposed on chronic interstitial inflammation and includes the first photographic evidence of an intranuclear inclusion in a myocardial fiber. The present report is of a 3-year-old girl, previously well and without known nervous system abnormality, rheumatic fever, or history of recent medication, but with known exposure to chickenpox, who died six days after onset of illness with fulminating varicella myocarditis and minimal pneumonitis.
Report of a Case
Clinical Course.—Five days prior