Severe Influenza A (H1N1) Myocarditis in a Pediatric Patient: A Case of ECMO Support and Neurological Sequelae

Introduction: For children, influenza A (H1N1)-induced fulminant myocarditis poses a major risk since it frequently results in abrupt heart failure and has a high mortality rate. To maintain circulation as the myocardium heals, early extracorporeal membrane oxygenation (ECMO) deployment may be essential. However, complications, including ischemic neuropathy and vascular damage, can have a significant effect on the patient’s recovery trajectory.Case Report: A previously healthy 8-year-old child had fever, cough, and severe chest pain. Her condition quickly worsened into cardiogenic shock when investigations indicated significant biventricular dysfunction caused by an H1N1 infection. By day 12 of her hospital stay, her circulation had normalized, and her heart had recovered upon receiving immediate venoarterial ECMO treatment. Her left lower limb weakness, which was consistent with ECMO-related neuropathy, persisted even after her heart improved, requiring continued rehabilitation.Discussion: This report demonstrates the life-saving role of ECMO in pediatric influenza myocarditis when introduced at an early stage. By stabilizing cardiac function and allowing time for recovery, ECMO can shift an otherwise critical trajectory toward a more favorable outcome. Nevertheless, clinicians must remain vigilant about vascular and neurological complications, emphasizing the necessity of thorough follow-up and interdisciplinary care.Conclusion: When combined with supportive measures such as physical therapy and neurological monitoring, prompt ECMO intervention can significantly improve both survival and quality of life for affected children.