Acute cytomegalovirus hepatitis in an immunocompetent host

Abstract

SUMMARYA 52-year-old woman presented with a 1-week history of recurrent fevers and joint pains accompanied by abdominal and low back discomfort. She has a history of hypoparathyroidism and is on calcium supplements. Physical examination revealed fever and tachycardia. The rest of the examination was normal. Laboratory tests showed newly increased transaminase activity. Serum bilirubin and prothrombin time were normal. She was admitted for evaluation of acute hepatitis. Serology for hepatitis A, B, C and HIV were negative. Her serum acetaminophen and alcohol were undetected. Abdominal imaging was normal. Cultures were sterile. Additional tests for uncommon viral hepatitis included herpes simplex virus, cytomegalovirus and Epstein-Barr virus. Liver biopsy revealed non-specific inflammation. Subsequently, cytomegalovirus serology showed an IgM positive and negative IgG titre. Cytomegalovirus DNA qualitative PCR was also positive. No antiviral medication was given. She continued to have intermittent daily fever but reported no associated symptoms. She was discharged 9 days after admission in stable condition per her request with the advice to follow-up in the clinic in 1 week. Her serum hepatic profile returned to normal and she reported no more episodes of fever. Repeated titres of cytomegalovirus serology showed seroconversion. BACKGROUND

A term infant with severe hypereosinophilia secondary to CMV infection and the STAT1 gene mutation: a case report

“…CMV has a broad infectivity range, it is typically associated with immunocompromised patients [13]. There are few documented cases of primary CMV infection associated with eosinophilia [14][15][16][17], although it is not uncommon for viral infections to be associated with eosinophilia, however, their antiviral abilities have been demonstrated mainly in respiratory syncytial virus (RSV) studies [18].…”

Hepatitis and Pancreatitis Secondary to Cytomegalovirus Infection in Immunocompetent Patient

“…The Cytomegalovirus (CMV) is a DNA virus belonging to the Herpesviridae group. Its seroprevalence is high within the general population (40 to 100%), with variations among ethnic groups and regions 6 CMV infections are usually mild or asymptomatic in immunocompetent adults and can clinically manifest during the primary infection or reactivation of the virus. Transmission can occur from mother to child in the perinatal or postnatal period, the virus can be acquired through saliva, sexual contact and blood, contamination through transplanted organs has been reported within literature 7 , there have been no communicated cases of transmission through inhaled aerosols 8 .…”

Acute CMV hepatitis in an immunocompetent patient

“…1 Systemic reviews demonstrated that CMV reactivation have a worse impact on host compared with primary CMV viremia. 7 Recent reports have highlighted severe CMV reactivation among immunocompetent critically ill individuals in ICU settings, which is associated with prolonged ICU stay and increased mortality. 3 CMV is usually maintained in a latent state within monocytes and dendritic cells.…”