{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T20:08:03Z","timestamp":1777493283237,"version":"3.51.4"},"reference-count":41,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2024,2,13]],"date-time":"2024-02-13T00:00:00Z","timestamp":1707782400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>Carditis in childhood is a rare disease with several etiologies. We report a case of infant death due to pericarditis and myocarditis after the mRNA vaccine against COVID-19 (COVIDmRNAV). A 7-year-old male child received the first dose of the COVIDmRNAV and presented with monoarthritis and a fever non-responsive to oral antibiotics. The laboratory investigation showed signs of infection (leukocytosis, high levels of c-reactive protein). His condition rapidly deteriorated, and the patient died. The autopsy identified pericardial fibrin deposits, hemorrhagic areas in the myocardium, and normal valves. A diffuse intermyocardial inflammatory infiltrate composed of T CD8+ lymphocytes and histiocytes was identified. An antistreptolysin O (ASO) dosage showed high titers. The presence of arthritis, elevated ASO, and carditis fulfills the criteria for rheumatic fever. However, valve disease and Aschoff\u2019s nodules, present in 90% of rheumatic carditis cases, were absent in this case. The temporal correlation with mRNA vaccination prompted its inclusion as one of the etiologies. In cases of myocardial damage related to COVID-19mRNAV, it appears to be related to the expression of exosomes and lipid nanoparticles, leading to a cytokine storm. The potential effects of the COVID-19mRNAV must be considered in the pathogenesis of this disease, whether as an etiology or a contributing factor to a previously initiated myocardial injury.<\/jats:p>","DOI":"10.3390\/vaccines12020194","type":"journal-article","created":{"date-parts":[[2024,2,14]],"date-time":"2024-02-14T04:18:22Z","timestamp":1707884302000},"page":"194","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Fatal Myocarditis following COVID-19 mRNA Immunization: A Case Report and Differential Diagnosis Review"],"prefix":"10.3390","volume":"12","author":[{"given":"Pedro Manuel Barros de","family":"Sousa","sequence":"first","affiliation":[{"name":"University Hospital of the Federal University of Maranh\u00e3o, Bar\u00e3o de Itapari Street 227, S\u00e3o Lu\u00eds 65020-070, MA, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elon Almeida","family":"Silva","sequence":"additional","affiliation":[{"name":"University Hospital of the Federal University of Maranh\u00e3o, Bar\u00e3o de Itapari Street 227, S\u00e3o Lu\u00eds 65020-070, MA, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcos Adriano Garcia","family":"Campos","sequence":"additional","affiliation":[{"name":"Clinical Hospital of Botucatu Medical School, S\u00e3o Paulo State University, Professor M\u00e1rio Rubens Guimar\u00e3es Montenegro Avenue, Botucatu 18618-687, SP, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joyce Santos","family":"Lages","sequence":"additional","affiliation":[{"name":"University Hospital of the Federal University of Maranh\u00e3o, Bar\u00e3o de Itapari Street 227, S\u00e3o Lu\u00eds 65020-070, MA, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rita da Gra\u00e7a Carvalhal Fraz\u00e3o","family":"Corr\u00eaa","sequence":"additional","affiliation":[{"name":"University Hospital of the Federal University of Maranh\u00e3o, Bar\u00e3o de Itapari Street 227, S\u00e3o Lu\u00eds 65020-070, MA, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gyl Eanes Barros","family":"Silva","sequence":"additional","affiliation":[{"name":"University Hospital of the Federal University of Maranh\u00e3o, Bar\u00e3o de Itapari Street 227, S\u00e3o Lu\u00eds 65020-070, MA, Brazil"},{"name":"Department of Pathology, Ribeir\u00e3o Preto Medical School, University of S\u00e3o Paulo, Ribeir\u00e3o Preto 14049-900, SP, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,2,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1542\/pir.2018-0044","article-title":"Acute Myocarditis and Pericarditis in Children","volume":"40","author":"Tunuguntla","year":"2019","journal-title":"Pediatr. 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