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International Journal of Medical Toxicology and Forensic Medicine

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  3. Vol. 16 (2026): Vol. 16 (2026)
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Vol. 16 (2026)

Dey 2026

Plasma Cell–Rich Viral Myocarditis Identified at Autopsy: A Case Report Prominent Plasma Cell Infiltration in Fatal Myocarditis Associated with Acute Respiratory Distress Syndrome and Multiorgan Injury

  • Samiramis Qavam
  • Mohamad Saeid Emaminia
  • Hanie Bakhtiyari
  • Mohamadreza Hafezi Ahmadi
  • Amin Bakhtiyari

International Journal of Medical Toxicology and Forensic Medicine, Vol. 16 (2026), 1 Dey 2026 , Page 1-4
https://doi.org/10.22037/ijmtfm.v16.52537 Published: 08/17/2026

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Abstract

Background: Viral myocarditis is a clinically significant inflammatory disease of the myocardium and a well-established cause of sudden and unexpected death, particularly in young and middle-aged individuals. Histopathological diagnosis at autopsy may be challenging, especially when inflammatory patterns deviate from classic lymphocytic predominance.

Case Presentation: We report the case of a 37-year-old man with a known history of chronic heart failure and seizures who presented with generalized weakness and died within 24 hours of hospital admission despite supportive management. A complete medicolegal autopsy with detailed histopathological examination was performed. Microscopic evaluation revealed plasma cell–rich lymphocytic myocarditis, accompanied by pathological findings consistent with acute respiratory distress syndrome (ARDS), including diffuse interstitial edema and inflammatory infiltration of the lungs. Additional findings included mild hepatitis and acute tubular necrosis, indicating multiorgan involvement.

Conclusion: The constellation of findings supports death due to fulminant viral myocarditis associated with systemic inflammatory response and secondary ARDS. This case highlights the diagnostic value of meticulous myocardial histopathological assessment, particularly the recognition of plasma cells as supportive evidence of viral myocarditis, and underscores the potential for rapid clinical deterioration and fatal outcome in patients with underlying cardiac disease.

Keywords:
  • Plasma cell–rich, Viral myocarditis, Autopsy
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How to Cite

Qavam, S., Emaminia, M. S., Bakhtiyari, H., Hafezi Ahmadi, M., & Bakhtiyari, A. (2026). Plasma Cell–Rich Viral Myocarditis Identified at Autopsy: A Case Report: Prominent Plasma Cell Infiltration in Fatal Myocarditis Associated with Acute Respiratory Distress Syndrome and Multiorgan Injury. International Journal of Medical Toxicology and Forensic Medicine, 16, 1–4. https://doi.org/10.22037/ijmtfm.v16.52537
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References

[1] Basso C, Calabrese F, Corrado D, Thiene G. Postmortem diagnosis in sudden cardiac death victims: macroscopic, microscopic and molecular findings. Cardiovasc Res. 2001;50(2):290-300. [DOI: 10.1016/s0008-6363(01)00261-9]

[2] Harris KM, Mackey-Bojack S, Bennett M, Nwaudo D, Duncanson E, Maron BJ. Sudden Unexpected Death Due to Myocarditis in Young People, Including Athletes. Am J Cardiol. 2021;143:131-4. [DOI: 10.1016/j.amjcard.2020.12.028]

[3] Lynge TH, Nielsen TS, Gregers Winkel B, Tfelt-Hansen J, Banner J. Sudden cardiac death caused by myocarditis in persons aged 1-49 years: a nationwide study of 14 294 deaths in Denmark. Forensic Sci Res. 2019;4(3):247-56. [DOI: 10.1080/20961790.2019.1595352]

[4] Kitulwatte ID, Kim PJ, Pollanen MS. Sudden death related myocarditis: a study of 56 cases. Forensic Sci Med Pathol. 2010;6(1):13-9. [DOI: 10.1007/s12024-009-9125-5]

[5] Maleszewski JJ, Banner J, de Boer H, De Gaspari M, Fishbein MC, Parsons S, et al. Lymphocytic myocarditis: A histopathologic definition and classification from the Society for Cardiovascular Pathology and Association for European Cardiovascular Pathology. II: Surgical and autopsy specimens. Cardiovascular Pathology. 2025;78:107748. [DOI: 10.1016/j.carpath.2025.107748]

[6] Thompson BT, Chambers RC, Liu KD. Acute Respiratory Distress Syndrome. N Engl J Med. 2017;377(6):562-72. [DOI: 10.1056/NEJMra1608077]

[7] Mann DL. Innate immunity and the failing heart: the cytokine hypothesis revisited. Circ Res. 2015;116(7):1254-68. [DOI: 10.1161/CIRCRESAHA.116.302317]

[8] Grune J, Bajpai G, Ocak PT, Kaufmann E, Mentkowski K, Pabel S, et al. Virus-Induced Acute Respiratory Distress Syndrome Causes Cardiomyopathy Through Eliciting Inflammatory Responses in the Heart. Circulation. 2024;150(1):49-61. [DOI: 10.1161/CIRCULATIONAHA.123.066433]

[9] McCarthy RE, 3rd, Boehmer JP, Hruban RH, Hutchins GM, Kasper EK, Hare JM, et al. Long-term outcome of fulminant myocarditis as compared with acute (nonfulminant) myocarditis. N Engl J Med. 2000;342(10):690-5. [DOI: 10.1056/NEJM200003093421003]

[10] Giordani AS, Baritussio A, Vicenzetto C, Peloso-Cattini MG, Pontara E, Bison E, et al. Fulminant Myocarditis: When One Size Does Not Fit All - A Critical Review of the Literature. Eur Cardiol. 2023;18:e15. [DOI: 10.15420/ecr.2022.54]

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