Post-measles Dilated Cardiomyopathy in an Eleven Months Old Infant: Acase Report

Abstract

Cardiomyopathy is an acquired heart muscle condition that is considered to be rare among children but carries substantial risk of morbidity and mortality. Dilated cardiomyopathy has been identified as the commonest form of cardiomyopathy, accounting for about 50% of all cases, with acute myocarditis causing 10-25% of cases of dilated cardiomyopathy. Measles virus is a reported rare cause of acute myocarditis. We report a case of an eleven-month-old infant who presented with fever, cough and difficulty in breathing. Her symptoms developed following an episode of measles infection she had at about 7 months of age during an outbreak of measles infection in her community. Examination revealed displaced apex, 3rd heart sound with gallop rhythm and tender hepatomegaly. Chest X-ray showed cardiomegaly with left ventricular apex. Echocardiography confirmed dilated left atrial and left ventricular chambers, mitral regurgitation and severe left ventricular systolic dysfunction. She was placed on frusemide, captopril and digoxin with significant improvement, and was discharged home. She was seen once in the clinic, and was subsequently lost to follow-up, until 7 weeks later when she returned and succumbed to death. Measles virus is a rare cause of myocarditis. A high index of suspicion is needed so as to minimize delay in diagnosis and increase chances of better treatment outcome.