Abstract

Myocarditis is an inflammation of the myocardium followed by necrosis and/or degeneration of myocytes [1]; caused by a viral [2] or bacterial infection [3]. Thus we have aimed this case of a six years old child (boy) presented in a local hospital, Rawalpindi, Pakistan. He has the complaints of high grade fever, vomiting, lower abdominal pain, anorexia, lethargy, respiratory depression with nasal flaring and body aches. The physician prescribed injection Ceftrioxone 750mg IV (intravenous) b.i.d (twice daily), syrup Disprol DS (double strength) t.i.d (thrice time a day), gel Dektarin T.D.S t.i.d, syrup Artem (Artemether and Lumefantrine) 5ml p.o (oral) b.i.d. Physician recommend ECG, CRP (C-reactive protein ) and cardiac enzymes. On basis of diagnosis the physician prescribed drugs for acute myocarditis were Tab Digoxin 0.25 1/4 b.i.d, Tab Renitec 5mg 1/4 o.d (once daily), Tab Spiromide 20mg 1/4+1/4 b.i.d. along with previous therapy. Certain queries and inaccuracies noted during the treatment so interactions and dosage were needed to adjusted properly to optimize the regimens. A combination of ACE inhibitors and spironolactone should be addressed with close monitoring in patients with renal insufficiency, worsening heart failure, dehydration and with medications that may cause hyperkalemia. Moreover; dose adjustment needed in concomitant conventional acute myocarditis along with frequent monitoring of electrolytes and renal parameters.