Moreno-Treviño MG, Garza-Garza GG, Ulloa-Ortiz Ó, Rivera-Silva G

Language: English
References: 15
Page: 60-62
PDF size: 263.36 Kb.

ABSTRACT

Cytomegalovirus (CMV) has high rates of seroprevalence and subclinical infection in the general population. The infection is habitually recognized in immunocompromised patients. However, in a state of immunocompetence, CMV usually presents as asymptomatic and is often revealed fortuitously on routine tests. A case of a 53-year-old female immunocompetent patient with CMV hepatitis is presented. Eight days prior to admission, the patient presented occasional fever, fatigue, myalgia and arthralgia associated with prior upper respiratory tract distress. The percutaneous liver biopsy revealed CMV inclusion bodies; CMV serology and the CMV DNA qualitative PCR test were positives. She was treated with ganciclovir. When patients present non-specific prodromal symptoms pertaining to acute hepatitis with an unclear etiology, CMV infection should be considered.

REFERENCES

1. Crough T, Khanna R. Immunobiology of human cytomegalovirus: from bench to bedside. Clin Microbiol Rev. 2009; 22 (1): 76-98.

2. Vancíková Z, Dvorák P. Cytomegalovirus infection in immunocompetent and immunocompromised individuals--a review. Curr Drug Targets Immune Endocr Metabol Disord. 2001; 1 (2): 179-187.

3. Eddlestone M, Peacock S, Juniper M, Warrell DA. Severe cytomegalovirus infection in immunocompetent patients. Clin Infect Dis. 1997; 24 (1): 52-56.

4. Gueddi S, Righini M, Mezger N, Morard I, Kaiser L, Giostra E et al. Portal vein thrombosis following a primary cytomegalovirus infection in an immunocompetent adult. J Thromb Haemost. 2006; 95 (1): 199-201.

5. Rafailidis PI, Mourtzoukou EG, Varbobitis IC, Falagas ME. Severe cytomegalovirus infection in apparently immunocompetent patients: a systematic review. Virol J. 2008; 5: 47.

6. Galiatsatos P, Shrier I, Lamoureux E, Szilagyi A. Meta-analysis of outcome of cytomegalovirus colitis in immunocompetent hosts. Dig Dis Sci. 2005; 50 (4): 609-616.

7. Azad AK, Ahmed T, Chowdhury AJ, Rahim MA, Mahmud AK, Rahman MA. Cytomegalovirus induced hepatitis in an immunocompetent host. Mymensingh Med J. 2008; 17 (2 Suppl): S104-S106.

8. Dupont L, Reeves MB. Cytomegalovirus latency and reactivation: recent insights into an age-old problem. Rev Med Virol. 2016; 26 (2): 75-86.

9. Schlick K, Grundbichier M, Auberger J, Kern JM, Hell M, Hohla F et al. Cytomegalovirus reactivation and its clinical impact in patients with solid tumors. Infect Agent Cancer. 2015; 10: 45.

10. Gupta P, Suryadevara M, Das A. Cytomegalovirus-induced hepatitis in an immunocompetent patient. Am J Case Rep. 2014; 15: 447-449.

11. Qian JY, Bai XY, Feng YL, Zhu WJ, Yao F, Li JN et al. Cholestasis, ascites and pancytopenia in an immunocompetent adult with severe cytomegalovirus hepatitis. World J Gastroenterol. 2015; 21 (43): 12505-12509.

12. Mamun M, Rahman S, Khan M. Acute cytomegalovirus hepatitis in immunocompetent host. KUMJ. 2009; 7 (25): 79-81.

13. Fernandez-Ruiz M, Munoz-Codoceo C, López-Medrano F, Faré-García R, Carbonnell-Porras A, Garfia-Castillo C et al. Cytomegalovirus myopericarditis and hepatitis in an immunocompetent adult: successful treatment with oral valganciclovir. Inter Med. 2008; 47 (22): 1963-1966.

14. Khattab MA, Eslam M, Abd-Elfattah ME. Encephalitis, acute renal failure, and acute hepatitis triggered by a viral infection in an immunocompetent young adult: a case report. J Med Case Rep. 2009; 3: 9289.

15. Yu YD, Park GC, Park PJ, Choi YI, Hwang S, Song GW et al. Cytomegalovirus infection-associated fulminant hepatitis in an immunocompetent adult requiring emergency living-donor liver transplantation: a report of a case. Surg Today. 2013; 43 (4): 42-48.