• Mingliang Sui, Weibing Tang, and Changjiang Wu.
• Department of Critical Care Medicine, Suzhou Kowloon Hospital, Shanghai Jiao Tong University School of Medicine, Suzhou, China.
• Medicine (Baltimore). 2018 Dec 1; 97 (49): e13582.

RationaleThe Epstein-Barr (EB) virus has rarely been reported as a cause of fulminant myocarditis. To our knowledge, the present case is the first report on myocardial calcification in EB viral myocarditis and rhabdomyolysis.Patient ConcernsA 17-year-old man was admitted to the department with fever, chest tightness, and tachypnea that had been present for 2 days.DiagnosesThe initial investigation showed elevated liver enzyme levels, creatine kinase levels, creatine kinase isoenzyme levels, and elevated serum myoglobin. Echocardiography showed that left ventricular motion amplitude decreased. Test for immunoglobin M and immunoglobin G antibodies against Epstein-Barr virus were positive. These findings were consistent with fulminant myocarditis, cardiogenic shock, and rhabdomyolysis.InterventionsThe patient was intensively treated with venoarterial extracorporeal membrane oxygenation (VA-ECMO), continuous renal replacement therapy (CRRT).OutcomesMyocardial calcification was observed in the left ventricle walls on CT examination 10 days after the admission. Four months later, the patient is still alive and with adequate daily life.LessonsThis case indicates that this rare form of myocardial calcification may be associated with EB viral infection and rhabdomyolysis.

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