{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T04:34:11Z","timestamp":1787891651590,"version":"build-2784847793"},"reference-count":40,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,5,21]],"date-time":"2024-05-21T00:00:00Z","timestamp":1716249600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Neonatal (enteroviral) myocarditis (NM\/NEM) is rare but unpredictable and devastating, with high mortality and morbidity. We report a case of neonatal coxsackievirus B (CVB) fulminant myocarditis successfully treated with veno-arterial extracorporeal membrane oxygenation (V-A ECMO).<\/jats:p><\/jats:sec><jats:sec><jats:title>Case presentation<\/jats:title><jats:p>A previously healthy 7-day-old boy presented with fever for 4 days. Progressive cardiac dysfunction (weak heart sounds, hepatomegaly, pulmonary edema, ascites, and oliguria), decreased left ventricular ejection fraction (LVEF) and fractional shortening (FS), transient ventricular fibrillation, dramatically elevated creatine kinase-MB (405.8\u2005U\/L), cardiac troponin I (25.85\u2005ng\/ml), and N-terminal pro-brain natriuretic peptide (NT-proBNP\u2009&amp;gt;\u200935,000\u2005ng\/L), and positive blood CVB ribonucleic acid indicated neonatal CVB fulminating myocarditis. It was refractory to mechanical ventilation, fluid resuscitation, inotropes, corticosteroids, intravenous immunoglobulin, and diuretics during the first 4 days of hospitalization (DOH 1\u20134). The deterioration was suppressed by V-A ECMO in the next 5 days (DOH 5\u20139), despite the occurrence of bilateral grade III intraventricular hemorrhage on DOH 7. Within the first 4 days after ECMO decannulation (DOH 10\u201313), he continued to improve with withdrawal of mechanical ventilation, LVEF\u2009&amp;gt;\u200960%, and FS\u2009&amp;gt;\u200930%. In the subsequent 4 days (DOH 14\u201317), his LVEF and FS decreased to 52% and 25%, and further dropped to 37%\u201338% and 17% over the next 2 days (DOH 18\u201319), respectively. There was no other deterioration except for cardiomegaly and paroxysmal tachypnea. Through strengthening fluid restriction and diuresis, and improving cardiopulmonary function, he restabilized. Finally, notwithstanding NT-proBNP elevation (&amp;gt;35,000\u2005ng\/L), cardiomegaly, and low LVEF (40%\u201344%) and FS (18%\u201321%) levels, he was discharged on DOH 26 with oral medications discontinued within 3 weeks postdischarge. In nearly three years of follow-up, he was uneventful, with interventricular septum hyperechogenic foci and mild mitral\/tricuspid regurgitation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Dynamic cardiac function monitoring via real-time echocardiography is useful for the diagnosis and treatment of NM\/NEM. As a lifesaving therapy, ECMO may improve the survival rate of patients with NM\/NEM. However, the \u201choneymoon period\u201d after ECMO may cause the illusion of recovery. Regardless of whether the survivors of NM\/NEM have undergone ECMO, close long-term follow-up is paramount to the prompt identification and intervention of abnormalities.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2024.1364289","type":"journal-article","created":{"date-parts":[[2024,5,21]],"date-time":"2024-05-21T04:55:46Z","timestamp":1716267346000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["V-A ECMO for neonatal coxsackievirus B fulminant myocarditis: a case report and literature 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