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Enteroviruses as a possible cause of myocarditis, pericarditis and dilated cardiomyopathy in Belém, Brazil.

We attempted to assess the role of enteroviruses in the etiology of myocarditis (MC), pericarditis (PC) and dilated cardiomyopathy (DCM) among 15 in-patients at a public hospital in Belém, Brazil, from November 1992 to December 1993. We obtained stool specimens and throat swabs from each patient (particularly acute cases) and, when possible, acute and convalescent serum samples for both isolation and serological procedures. MC, PC and DCM occurred in 10, 2 and 3 patients, respectively, mostly in the 0- to 10-year age group. Neutralizing antibody seroconversions were detected as follows: one for Coxsackievirus (Cox) B2 in one patient suffering from MC, and two for Cox B4, in patients with DCM and MC. In addition, antibody titers of 1/320 against Cox B2 and Cox B4 were noted in two other patients, one suffering from PC and the other presenting MC. Isolation of echovirus (ECHO) serotype 1 was recorded in a patient with MC, without either seroconversion or high antibody levels for Cox B 1 to 6. These results indicate that enteroviruses may be involved in the etiology of MC, PC and DCM in the Amazon region.