Fulminant dengue myocarditis requiring VA ECMO support

Dengue is endemic disease in India and tropical countries. It has a wide spectrum of presentation varying from asymptomatic to manifest as undifferentiated fever, dengue fever, dengue shock syndrome or dengue haemorrhagic fever. An increasing number of cases of dengue are being reported with atypical presentations such as dengue encephalitis, secondary bacterial infections, pericardial effusion, myocarditis, cardiac rhythm disturbances like supraventricular tachycardia, conduction block etc. Dengue is caused by RNA virus of flaviviridae group and has four serotypes- DENV 1–4. Of these type, type 2 (DENV-2) is associated with unusual manifestations of dengue like myocarditis [1,2]. Early identification and prompt treatment of these uncommon presentations improves the outcome as these complications are temporary and reversible manifestations. Here we report case of severe myocarditis in dengue with complete recovery following ECMO support.