Volume 26, Issue 5 e14275
CASE REPORT

Necrotizing enterovirus myositis in a pediatric renal transplant recipient

Kristen G. Valencia Deray

Corresponding Author

Kristen G. Valencia Deray

Division of Infectious Diseases, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA

Correspondence

Kristen G. Valencia Deray, Division of Infectious Diseases, Department of Pediatrics, Baylor College of Medicine, 1102 Bates Street Suite 1120, Houston, TX 77030, USA.

Email: [email protected]

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Margaret G. Taylor

Margaret G. Taylor

Division of Infectious Diseases, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA

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Melissa M. Blessing

Melissa M. Blessing

Department of Pathology & Immunology, Baylor College of Medicine, Houston, Texas, USA

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Claire E. Bocchini

Claire E. Bocchini

Division of Infectious Diseases, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA

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Erica K. Schallert

Erica K. Schallert

Edward B. Singleton Department of Radiology, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA

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Daniel Ruderfer

Daniel Ruderfer

Division of Infectious Diseases, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA

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Poyyapakkam R. Srivaths

Poyyapakkam R. Srivaths

Renal Section, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA

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Rossana Malatesta Muncher

Rossana Malatesta Muncher

Renal Section, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA

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First published: 27 March 2022
Citations: 1

Abstract

Background

Enteroviruses can cause severe infections, including viral myocarditis, meningitis, acute flaccid myelitis, and viral myositis.

Methods/Results

We report a 3-year-old female renal transplant recipient who presented to a tertiary care hospital with elevated serum liver aminotransferases and subsequently developed proximal muscle pain, weakness, and respiratory distress during the first week of hospitalization. Imaging of the lower extremities revealed diffuse myositis of the proximal thigh and pelvic muscles. A muscle biopsy was obtained and revealed necrotizing myositis with immunostaining positive for enterovirus, consistent with a diagnosis of enterovirus necrotizing myositis. She had complete resolution of symptoms with steroids, intravenous immune globulin, reduced tacrolimus dose, and physical therapy.

Conclusions

Enterovirus myositis should be included in the differential diagnosis for necrotizing myositis following renal transplantation in children.

CONFLICT OF INTEREST

All authors declared no conflict of interests.

DATA AVAILABILITY STATEMENT

Data sharing not applicable to this article as no datasets were generated or analyzed during the current study.

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