Criteria for myocarditis or pericarditis – one or both of the following:
(1) culture from pericardial tissue or fluid (obtained by needle aspiration or at surgery) is positive for micro-organisms
(2) all of the following:
(2a) 2 or more of the following
(2a1) fever > 38°C (rectal if <= 1 year of age)
(2a2) chest pain AND > 1 year in age
(2a3) increased heart size
(2a4) paradoxical pulse
(2a5) age <= 1 year AND hypothermia (< 37°C rectal)
(2a6) age <=1 year AND apnea
(2a7) age <= 1 year AND bradycardia
(2b) no other recognized cause
(2c) one or more of the following
(2c1) abnormal ECG consistent with pericarditis or myocardiits
(2c2) positive antigen test performed on blood
(2c3) evidence of myoarditis or pericarditis on histologic exam
(2c4) positive serologic response (single IgM titer or 4-fold increase in IgG antibody) with or without isolation of a virus from pharynx or feces
(2c5) pericardial effusion identified on imaging studies
where:
• Age <=1 year may refer to an infant (age <= 12 months) or a young child < 24 months.
• Myocardial dysfunction on imaging studies can be seen in myocarditis.
