Mechanism of Yi-xin-yin oral liquid according to homotherapy for heteropathy theory based on UHPLC-Q-TOF/MS combined with network pharmacology and molecular docking techniques / 中国临床药理学与治疗学

AIM: To predict the core targets and related signaling pathways of Yi-xin-yin oral liquid for the treatment of arrhythmia, heart failure and myocarditis based on UHPLC-Q-TOF/MS, network pharmacology, molecular docking methods, cell experiments, according to the“homotherapy for heteropathy”theory in traditional Chinese medicine. METHODS: UHPLC-Q-TOF / MS was used to analyze and identify the chemical composition of Yi-xin-yin oral liquid Extract and the blood-absorbing components of rats oral administrated with Yi-xin-yin oral liquid extract, which compounds were applied in the databases searching for the potential targets (TCMSP, SwissTargetPrediction) and disease targets (OMIM, Genecard). Venn diagram was used for target intersection, and the subsequent protein-protein interaction network obtained core targets by STRING11.5 database, and then construct a "disease-component-target" network by cytoscape3.9.0. Finally, DAVID database was used to analysis GO function and KEGG enrichment analysis of core targets, and molecular docking validation was performed using Autodock vina software. And, validated with H9c2 cells for potential active ingredients and targets. RESULTS: A total of 156 compounds were identified from Yi - xin-yin Oral Liquid extract; 34 compounds were identified from rat serum, including 6-gin-gerol, isoliquiritigenin, glycyrrhizic acid and other compounds, and 139 intersecting targets were obtained. The KEGG pathway enrichment analysis mainly involved the TNF signaling pathway, IL-17 signaling pathway, MAPK signaling pathway, PI3K-Akt signaling pathway and so on. The TNF and IL-6 targets were selected for molecular docking with the main compounds, and the docking results were good (less than -5 kcal/mol). In vitro cellular experiments have shown that Yi-xin-yin oral liquid can exert therapeutic effects by regulating TNF and IL-6. CONCLUSION: The main potential active ingredients of Yi-xin-yin oral liquid may be isoliquiritigenin, glycyrrhetinic acid, calycosin-7-glucoside, salvianolic acid B, and 6-gingerol, which mainly act on TNF, IL-6 and other targets to regulate specific signaling pathways and exert therapeutic effects.

Fulminant Necrotizing Eosinophilic Myocarditis Successfully Treated With Veno-Arterial Extracorporeal Membrane Oxygenation and High-Dose Steroids

Abstract Fulminant necrotizing eosinophilic myocarditis (FNEM) is a rare form of EM characterized by biventricular heart failure with hemodynamic deterioration, often requiring inotropes or mechanical circulatory support. Here, we report a case of a 43-year-old healthy woman with FNEM who was admitted with acute heart failure that rapidly progressed to cardiogenic shock and electrical storm, culminating in cardiac arrest. Early diagnosis and prompt administration of corticosteroids in combination with veno-arterial extracorporeal membrane oxygenation allowed complete recovery of biventricular systolic function.

Dolor torácico agudo en pacientes jóvenes: reporte de dos casos / Acute chest pain in young patients: report of two cases

Se presentan dos casos clínicos de pacientes jóvenes con dolor torácico agudo, en ellos, el enfoque multidisciplinario y la resonancia magnética cardíaca jugaron un papel crucial en el diagnóstico y tratamiento. Presentación del caso 1. Un paciente de 20 años con dolor precordial y palpitaciones que mostró elevación de los niveles de enzimas cardíacas en los exámenes de laboratorio. La angiografía coronaria no reveló estenosis significativas. Sin embargo, se confirmó el diagnóstico de miocarditis a través de la resonancia magnética cardíaca, lo que llevó al inicio del tratamiento con medicamentos para lograr una función cardíaca adecuada y la prevención del progreso de la enfermedad. Su evolución clínica fue favorable. Presentación del caso 2. Un paciente de 19 años que presentó un dolor torácico intenso que se irradiaba al brazo izquierdo y mandíbula. Los exámenes de laboratorio reportaron elevación de los niveles de troponinas, que generaron la sospecha de un síndrome coronario agudo. La resonancia magnética cardíaca confirmó el diagnóstico de un infarto agudo de miocardio, y la angiografía coronaria reveló una estenosis significativa en la arteria descendente anterior y una ectasia subsiguiente. Durante la hospitalización, se brindó un enfoque terapéutico integral con la administración de medicamentos, monitoreo, control del dolor y prevención de complicaciones, y el paciente mostró una evolución clínica favorable

Two clinical cases of young patients with acute chest pain are presented, where the multidisciplinary approach and cardiac magnetic resonance played a crucial role in diagnosis and treatment. Case presentation 1. A 20 year old patient with precordial pain and palpitations showed elevated cardiac enzyme levels on laboratory examination. Coronary angiography revealed no significant stenosis. However, the diagnosis of myocarditis was confirmed by cardiac magnetic resonance imaging, which led to the initiation of drug treatment to achieve adequate cardiac function and prevention of disease progression. His clinical evolution was favorable. Case presentation 2. 19 year old patient presented with severe chest pain radiating to the left arm and jaw. Laboratory tests reported elevated troponin levels, which raised the suspicion of acute coronary syndrome. Cardiac magnetic resonance imaging confirmed the diagnosis of acute myocardial infarction, and coronary angiography revealed significant stenosis in the anterior descending artery and subsequent ectasia. During hospitalization, a comprehensive therapeutic approach with medication administration, monitoring, pain control, and prevention of complications was provided, and the patient showed a favorable clinical evolution

Clinico-Epidemiological Profile and Predictors of Poor Outcome Among Children During a Diphtheria Outbreak in Haryana

Objective: To study the clinico-epidemiological profile and predictors of poor outcome in an outbreak of diphtheria. Methods: Records of 390 children admitted with the diagnosis of clinical diphtheria in a tertiary care teaching hospital in Nuh, Haryana, from January, 2018 to December, 2020 were analysed with respect to demographic details, immunization status, clinical features, complications and mortality. Patients were divided into survivors and nonsurvivors, and various variables were compared between the two groups to identify the factors associated with poor outcome. Results: Out of 390 cases, data of 318 (81.5%) was included. Young children (median age 5 year) were predominantly affected, and only 8 (2.5%) children were fully immunized. Pseudomembrane was present in 245 (77%) cases. Albert staining and culture were positive in 84.6% (269) and 12.9% (41) cases, respectively. Complications developed in 48.4% (n=154) cases and included: airway compromise 22.6% (n=72), diphtheritic cardiomyopathy 12.9% (n=41), acute kidney injury 3.7% (n=12), thrombocytopenia 8.5% (n=27) and hepatitis 0.6% (n=2) cases. Anti-diphtheritic serum (ADS) was administered to all admitted patients. Tracheostomy was done in (n=57) (17.9%) children. Case fatality rate was 17.9%. Conclusion: Diphtheria mostly affected young unvaccinated or partially vaccinated children. Mortality was high in unimmunized or partially immunized young children and those with bull neck, pseudomembrane, delayed (?5 days) administration of ADS, acute kidney injury, thrombocytopenia and leukocytosis. Myocarditis was strongly associated with high mortality.

COVID-19 vaccination in children: a public health priority

Abstract Objective: Covid-19 had a direct impact on children's health. The aim of this review was to analyze epidemiological and clinical data, the consequences of the pandemic, and vaccination aspects in this group. Sources of data: The searches were carried out from January 2020 to November 2022, in the MEDLINE databases (PubMed) and publications of the Brazilian Ministry of Health and the Brazilian Society of Pediatrics. Summary of findings: Covid-19 has a mild presentation in most children; however, the infection can progress to the severe form and, in some cases, to MIS-C. The prevalence of the so-called long Covid in children was 25.24%. Moreover, several indirect impacts occurred on the health of children and adolescents. Vaccination played a crucial role in enabling the reduction of severe disease and mortality rates. Children and adolescents, as a special population, were excluded from the initial clinical trials and, therefore, vaccination was introduced later in this group. Despite its importance, there have been difficulties in the efficient implementation of vaccination in the pediatric population. The CoronaVac vaccines are authorized in Brazil for children over three years of age and the pediatric presentations of the Pfizer vaccine have shown significant effectiveness and safety. Conclusions: Covid-19 in the pediatric age group was responsible for the illness and deaths of a significant number of children. For successful immunization, major barriers have to be overcome. Real-world data on the safety and efficacy of several pediatric vaccines is emphasized, and the authors need a uniform message about the importance of immunization for all children.

Sacubitril/valsartan inhibit viral replication and cardiomyocyte apoptosis in mice with CVB3-induced viral myocarditis via PI3K/AKT pathway / 中华微生物学和免疫学杂志

Objective:To observe the effects of sacubitril/valsartan (LCZ696) on viral replication and cardiomyocyte apoptosis in mice with coxsackievirus B3 (CVB3)-induced viral myocarditis (VMC) and to analyze the underlying mechanisms.Methods:Forty BALB/c mice were randomly divided into four groups with 10 in each group: Sham, Sham+ LCZ696, VMC, and VMC+ LCZ696 groups. VMC model was established by intraperitoneal injection of 0.1 ml of CVB3 with a concentration of 10 6 TCID 50/ml into BALB/c mice, while the sham intervention was an equal volume of saline. The day of virus injection was defined as day 0. LCZ696 was administered by gavage at a dose of 60 mg/kg every day for seven consecutive days starting from day 1. Mouse survival rates were calculated. Echocardiography was used to evaluate the cardiac function of mice. The level of creatine kinase-MB (CK-MB) was detected by ELISA. Western blot was used to detect the levels of inflammatory cytokines (IL-6, TNF-α), apoptosis-related proteins (caspase-3, cleaved-caspase-3, Bax, Bcl-2), CVB3 surface protein (VP-1) and p-AKT/AKT in the hearts of mice. CVB3 mRNA in mouse hearts was measured by PCR. Inflammatory cell infiltration and cell apoptosis in mouse hearts were observed by HE staining and TUNEL staining, respectively. Results:Compared with the Sham group, the mice in the VMC group had a decreased survival rate and impaired cardiac function ( P<0.05). The levels of CK-MB, IL-6, TNF-α, cleaved-caspase-3/caspase-3, Bax/Bcl-2, VP-1, and CVB3 mRNA in the hearts of VMC mice increased significantly ( P<0.05), accompanied by increased expression of AKT, decreased phosphorylation of AKT ( P<0.05) and increased cell apoptosis. LCZ696 reversed the above changes. It could increase the survival rate, improve the cardiac function ( P<0.05), decrease cardiac inflammation, cell apoptosis and viral replication ( P<0.05), and increase the phosphorylation of AKT ( P<0.05). LCZ696 had no significant effects on the survival rate, cardiac function, myocardial injury, cardiac inflammation, cell apoptosis, viral replication or the expression of PI3K/AKT signaling pathway-related proteins in normal mice. Conclusions:LCZ696 could significantly inhibit cardiomyocyte apoptosis and reduce CVB3 replication in the hearts of VMC mice by regulating the PI3K/AKT pathway, thereby improving mouse cardiac function and survival rate.

Progress in the diagnosis and treatment of pediatric myocarditis / 国际儿科学杂志

Myocarditis is an inflammatory disease of myocardium caused by a variety of factors.The most common etiology is enterovirus, followed by respiratory viruses, especially the new coronaviruses, mycoplasma, rickettsia, and toxoplasma, etc.The probability of arrhythmia is relatively high in myocarditis due to increased myocardial susceptibility, and its type may be suggestive of disease progression and prognosis.Electrophysiological changes in the cardio-myocytes are observed by electrocardiography and ambulatory electrocardiography.Echocardiography and cardiac magnetic resonance are used to detect specific changes in the internal structure of the myocardium and left ventricular systolic function and to assist in the diagnosis.For the treatment of myocarditis, in addition to general treatment, according to the needs of the condition, intravenous immunoglobulin, glucocorticoids, and receptor antagonists of some cytokines can be used.The prognosis of pediatric myocarditis is related to the type of myocarditis, the speed of progression, the degree of myocardial damage, the electrophysiological changes and the structural changes of the heart.

A review of COVID-19 vaccination and the reported cardiac manifestations

In Singapore, 9.03 million doses of the mRNA COVID-19 vaccines by Pfizer-BioNTech and Moderna have been administered, and 4.46 million people are fully vaccinated. An additional 87,000 people have been vaccinated with vaccines in World Health Organization's Emergency Use Listing. The aim of this review is to explore the reported cardiac adverse events associated with different types of COVID-19 vaccines. A total of 42 studies that reported cardiac side effects after COVID-19 vaccination were included in this study. Reported COVID-19 vaccine-associated cardiac adverse events were mainly myocarditis and pericarditis, most commonly seen in adolescent and young adult male individuals after mRNA vaccination. Reports of other events such as acute myocardial infarction, arrhythmia and stress cardiomyopathy were rare. Outcomes of post-vaccine myocarditis and pericarditis were good. Given the good vaccine efficacy and the high number of cases of infection, hospitalisation and death that could potentially be prevented, COVID-19 vaccine remains of overall benefit, based on the current available data.

Fasudil exerts a protective effect on down-regulation of IL-6 expression by inhibiting the NOTCH signaling pathway in EAM mice / 西安交通大学学报(医学版)

【Objective】 To explore the effect and mechanism of Fasudil in the treatment of experimental autoimmune myocarditis (EAM) in mice so as to provide a theoretical basis for the clinical use of Fasudil in treating myocarditis. 【Methods】 Balb/c male mice were used as the research objects, and the EAM mice model was constructed using MyHC-α614-629 polypeptide. Mononuclear cells were isolated and cultured to detect the number of mononuclear cells in mouse spleen. Inflammation infiltration, fibrosis and IL-6 expression in mouse myocardial tissue were detected by HE staining, Masson staining and immunohistochemistry, respectively. The protein expressions of Notch1 and IL-6 were detected by Western blotting. qRT-PCR was used to detect the expressions of pro-inflammatory factors (IL-1α, IL-1β and IL-6) as well as key genes of TLRs and NOTCH signaling pathway. 【Results】 EAM mice showed increased HW, decreased BW, increased HW/e-BW, and increased inflammatory infiltration and fibrosis in myocardial tissue. The above-mentioned symptoms or pathological features were improved in EAM mice treated with Fasudil. The analysis showed that the pro-inflammatory factors IL-1α, IL-1β and IL-6 in the myocardial tissue of EAM mice were significantly increased, but only the expression of IL-6 was statistically different after Fasudil treatment compared with the control group. In addition, TLRs signaling pathway might also play an important role in the EAM mice treated with Fasudil. The expressions of IL-6 and Notch1 were consistent, and the expressions of the key genes of NOTCH signaling pathway (Notch1, Hes1 and Jag2) were down-regulated after Fasudil treatment. 【Conclusion】 Fasudil exerts a protective effect on down-regulation of IL-6 expression by inhibiting the NOTCH signaling pathway in EAM mice.

Study on protective effect of Shenqi Fuzheng injection on immune myocarditis injury induced by anti-PD-1 antibody / 中国药理学通报

Aim To investigate the effeot of Shenqi Fuzheng injection on the prevention of immune myocarditis induced by anti-PD-1 antibody by reducing the production of inflammatory factors and the expression of myocardial injury markers. Methods Thirty-two maie PD-1 humanized mice with C57BL/6 genetic background were randomly divided into control group, myocarditis model group, anti-PD-1 antibody group and Shenqi Fuzheng injection group (n = 8). Except the control group, mice in other groups were intraperitoneally injected with myocardial myosin heavy chain peptide (5 mg • kg

Avaliação Ecocardiográfica com Strain do Envolvimento Miocárdico em Pacientes com Dor Torácica Contínua após Infecção por COVID-19 / Strain Echocardiographic Evaluation of Myocardial Involvement in Patients with Continuing Chest Pain after COVID-19 Infection

Resumo Fundamento Tem surgido uma nova manifestação clínica chamada pós-COVID ou COVID longa (COVID p/l) após a fase aguda da COVID-19. COVID p/l pode levar à lesão miocárdica com problemas cardíacos subsequentes. Diagnosticar esses pacientes de forma rápida e simples é cada vez mais importante devido ao número crescente de pacientes com COVID p/l. Objetivos Comparamos os parâmetros de ecocardiografia com strain (ES) de pacientes que apresentaram dor torácica atípica e achados de sequelas de miocardite na ressonância magnética cardíaca (RMC). Nosso objetivo foi investigar o valor da ES para detecção de envolvimento miocárdico em pacientes com COVID p/l. Métodos Foram incluídos um total de 42 pacientes. Nossa população foi separada em 2 grupos. O grupo RMC(-) (n = 21) não apresentou sequelas miocárdicas na RMC, enquanto o grupo RMC(+) apresentou sequelas miocárdicas na RMC (n = 21). O valor preditivo da ES para miocardite também foi avaliado por análise multivariada ajustada por idade. Valores de p < 0,05 foram considerados estatisticamente significativos. Resultados Quando comparado com a fração de ejeção do ventrículo esquerdo (FEVE), o strain longitudinal global (SLG) e o strain circunferencial global (SCG) tiveram uma relação mais forte (FEVE, p = 0,05; SLG, p < 0,001; SCG, p < 0,001) com envolvimento miocárdico associado à COVID p/l. SLG < 20,35 apresentou sensibilidade de 85,7% e especificidade de 81%; SCG < 21,35 apresentou sensibilidade de 81% e especificidade de 81% como valores diagnósticos para sequelas miocárdicas detectadas com RMC. Enquanto não houve diferença entre os grupos quanto aos marcadores inflamatórios (proteína C-reativa, p = 0,31), houve diferença entre os marcadores bioquímicos, que são indicadores de envolvimento cardíaco (peptídeo natriurético cerebral, p < 0,001). Conclusão A ES é mais útil do que a ecocardiografia tradicional para diagnosticar com rapidez e precisão, a fim de não atrasar o tratamento na presença de envolvimento miocárdico.

Abstract Background A new clinical manifestation called post or long coronavirus disease (p/l COVID) has walked into our lives after the acute COVID-19 phase. P/l COVID may lead to myocardial injury with subsequent cardiac problems. Diagnosing these patients quickly and simply has become more important due to the increasing number of patients with p/l COVID. Objectives We compared strain echocardiography (SE) parameters of patients who suffered from atypical chest pain and had sequel myocarditis findings on cardiac magnetic resonance (CMR). We aimed to investigate the value of SE for detection of myocardial involvement in patients with p/l COVID. Methods A total of 42 patients were enrolled. Our population was separated into two groups. The CMR(-) group (n = 21) had no myocardial sequelae on CMR, whereas the CMR(+) group had myocardial sequelae on CMR (n = 21). The predictive value of SE for myocarditis was also evaluated by age-adjusted multivariate analysis. P values < 0.05 were considered statistically significant. Results When compared with left ventricular ejection fraction (LVEF), global longitudinal strain (GLS) and global circumferential strain (GCS) had a stronger relationship (LVEF, p = 0.05; GLS, p < 0.001; GCS, p < 0.001) with p/l COVID associated myocardial involvement. GLS < 20.35 had 85.7% sensitivity and 81% specificity; GCS < 21.35 had 81% sensitivity and 81% specificity as diagnostic values for myocardial sequelae detected with CMR. While there was no difference between the groups in terms of inflammatory markers (C-reactive protein, p = 0.31), a difference was observed between biochemical markers, which are indicators of cardiac involvement (brain natriuretic peptide, p < 0.001). Conclusion SE is more useful than traditional echocardiography for making diagnosis quickly and accurately in order not to delay treatment in the presence of myocardial involvement.

Covid-19 and Heart Involvement: A Systematic Review of Literature

Abstract Background Recent reports in the literature have indicated that infection by coronavirus disease 2019 (COVID-19) causes cardiac complications, such as heart failure, arrhythmia, myocardial infarction, and even fulminant myocarditis. These complications have been identified as the cause of death in some patients infected with SARS-CoV-2. Objectives To analyze echocardiographic and electrocardiographic changes, treatments used, and clinical outcomes in patients with myocarditis and COVID-19. Methods The items described for Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were followed. This review included articles in English, Portuguese, and Spanish that reported cardiac involvement, injury, or myocardial inflammation in patients who acquired COVID-19 (SARS-CoV-2). Results Five databases were consulted to find 1,726 articles. After applying the eligibility criteria, a total of 22 studies were considered qualified. ST-segment (section of the electrocardiogram corresponding the end of the S wave to the beginning of the T wave) elevation and tachyarrhythmia were the most common changes found in the electrocardiographic analysis of patients affected with COVID-19. Concerning echocardiography, there was a high frequency of decreased ejection fraction and occurrence of pericardial effusion. Conclusion This systematic review provides a potential tool for the analysis of cardiac changes and implications caused in patients affected by SARS-CoV-2 infection, with emphasis on the presence of tachyarrhythmia on electrocardiogram (ECG) and decreased ejection fraction on echocardiogram.

Cardiac Manifestations Associated With Coronavirus Disease: A Case Report

Abstract This study presents a 47-year-old female patient, with a history of diabetes, who contracted SARS-CoV-2 and exhibited cardiovascular complications.

Zonulina e Presepsina Poderiam ser Biomarcadores e Alvos Terapêuticos para Miocardite Aguda? / Could Zonulin and Presepsin Be Biomarkers and Therapeutic Targets for Acute Myocarditis?

Resumo Fundamento O diagnóstico de miocardite aguda geralmente é feito diante de parâmetros clínicos e laboratoriais, podendo, por vezes, ser confundido com doenças que compartilham de características clínicas semelhantes, o que dificulta o diagnóstico. Sendo assim, o uso de biomarcadores mais específicos, para além dos clássicos como a troponina, acelerará o diagnóstico. Além disso, esses biomarcadores podem nos ajudar a compreender melhor o mecanismo de desenvolvimento da miocardite e, assim, prever resultados clínicos imprevisíveis. Objetivo Este estudo tem como objetivo revelar a possível relação entre permeabilidade intestinal e miocardite aguda. Métodos Neste estudo, buscamos avaliar os níveis séricos de zonulina e presepsina em 138 indivíduos consecutivos, incluindo 68 pacientes com miocardite e outros 70 usados como grupo controle, pareados por idade, sexo e fatores de risco cardiovascular. Valores de p < 0,05 foram considerados estatisticamente significativos. Resultados Em comparação com o grupo controle, zonulina e presepsina foram significativamente maiores no grupo de pacientes com miocardite (p < 0,001, para todos). Os níveis de zonulina foram positivamente correlacionados com presepsina, pico de CK-MB e níveis máximos de troponina (r = 0,461, p < 0,001; r = 0,744, p < 0,001; r = 0,627, p < 0,001; respectivamente). Na análise de regressão, presepsina e zonulina foram determinadas como preditores independentes para miocardite (OR de 1,002, IC de 95% 1,001-1,003, p = 0,025; OR de 12,331, IC de 95% 4,261-35,689; p < 0,001; respectivamente). O valor preditivo de miocardite aguda de presepsina e zonulina na análise da curva ROC foi estatisticamente significativo (p < 0,001, para ambos). Conclusão Este estudo mostrou que a zonulina e a presepsina podem ser biomarcadores para o diagnóstico de miocardite e também podem ser alvos terapêuticos para esclarecer o mecanismo de desenvolvimento da miocardite.

Abstract Background The diagnosis of acute myocarditis is usually made with clinical and laboratory parameters. This can sometimes be mixed up with diseases that have similar clinical features, making the diagnosis difficult. Therefore, the use of more specific biomarkers, in addition to the classically used biomarkers such as troponin, will accelerate the diagnosis. In addition, these biomarkers may help us to understand the mechanism of myocarditis development and thus predict unpredictable clinical outcomes. Objective This study aims to reveal the possible relationship between intestinal permeability and acute myocarditis. Methods In this study, we wanted to evaluate serum levels of zonulin and presepsin in 138 consecutive subjects, including 68 patients with myocarditis and another 70 as the control group, matched for age, gender, and cardiovascular risk factors. P-values <0.05 were considered to be statistically significant. Results Compared to the control group, zonulin and presepsin were significantly higher in the patient group with myocarditis (p < 0.001, for all). Zonulin levels were positively correlated with presepsin, peak CK-MB, and peak troponin levels (r = 0.461, p < 0.001; r = 0.744, p < 0.001; r = 0.627, p < 0.001; respectively). In regression analysis, presepsin and zonulin were determined as independent predictors for myocarditis (OR 1.002, 95% CI 1.001-1.003, p = 0.025; OR 12.331, 95% CI 4.261-35.689; p < 0.001; respectively). The predictive value of acute myocarditis of presepsin and zonulin in ROC curve analysis was statistically significant (p < 0.001, for both). Conclusion This study showed that zonulin and presepsin could be biomarkers that can be used in the diagnosis of myocarditis, and they can also be therapeutic targets by shedding light on the developmental mechanism of myocarditis.

Characteristic of cardiac and neurological forms of non-polio enterovirus infection

Enterovirus infections (EVI) are ubiquitous and generally present with mild symptoms and have a favorableprognosis with full recovery. But sometimes it can be challenging to diagnose mixed forms of EVI which can result in fatal outcomes. An interesting case report on a patient admitted to the Grodno Regional infectious diseases clinical hospital. The patientwas diagnosed with enteroviral infection. Histological slides of the brain, heart, lung and other systemic organs were prepared on autopsy and are presented in this scientific paper. Generalized EVI in mixed form can cause primary lesions of the brain (destructive edema), the heart (necrotizing cardiomyopathy), and sepsis while also affecting other organ systems. This can lead to unfavorable outcomes similar to that in our case report. Mixed form EVI (meningitis, myocarditis, and sepsis) can progress rapidly towards an adverse course, with the development of severe life-threatening complications. We strongly suggest that mandatory PCR screening for EVI should be carried out in young individuals with sepsis-like diseases and with a fever of unexplained origin at the time of presentation.