A Rare Case of Fulminant Myocarditis Caused by Epstein-Barr Virus Infection in a Middle-Aged Man

BACKGROUND: Fulminant myocarditis (FM) is a highly lethal syndrome of abrupt, diffuse cardiac inflammation that precipitates rapid-onset hemodynamic collapse. FM caused by Epstein-Barr virus (EBV) is rare and infrequently reported. METHODS: We reported a case of EBV-related FM in a man with respiratory and circulatory failure. RESULTS: The clinical diagnosis was made based on the patient's signs, ECG, ECHO, and significantly elevated levels of inflammatory factors and myocardial injury markers. The etiology was confirmed by mNGS detection of EBV DNA. The patient was successfully treated with VA-ECMO combination with medication therapy. CONCLUSIONS: The risk of FM precipitated by EBV infection should not be underestimated. Prompt recognition, targeted therapy, and early circulatory support may avert fatal outcomes.