Cytomegalovirus-Associated Splenic Infarction in a Young Female Patient

Pakkiyaretnam, Mayurathan; Horne, Christoper; Sarr, Louise; Parsad, Meenakshi; Chong, Jimmy

doi:10.7759/cureus.10801

Cited by 4 publications

(4 citation statements)

References 6 publications

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“…Recently, splenic infarction has been described in infections such as malaria,[ 9 ] Epstein bar virus,[ 10 ] and cytomegalovirus. [ 11 ] The exact mechanism for splenic infarct in infectious diseases is still obscured but proposed presumptions include transient hypercoagulable state, vascular occlusion due to increased circulating immune complexes and cellular stacking, and imbalance between blood supply and demand of large hypercellular spleen. [ 12 ]…”

Section: Discussionmentioning

confidence: 99%

Salmonella paratyphi-induced splenic vein thrombosis

Saini

Jesrani

Gupta

et al. 2021

Turkish Journal of Emergency Medicine

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Splenic vein thrombosis and splenic infarction are complications beyond the usual clinical spectrum of paratyphoid fever, and the presentation is rarely described. We report the case of a young female, who presented with high-grade fever and severe left upper quadrant pain. Her blood culture was positive for Salmonella paratyphi A, with Widal test suggesting 4-fold rise in titers. Computed tomography revealed splenic vein thrombosis and multiple splenic infarcts, for which antibiotic and anticoagulation were instituted simultaneously. She had a complete resolution with this management, and anticoagulation was tapered off on subsequent visits.

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Section: Discussionmentioning

confidence: 99%

Salmonella paratyphi-induced splenic vein thrombosis

Saini

Jesrani

Gupta

et al. 2021

Turkish Journal of Emergency Medicine

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“…Infection Cytomegalovirus [6][7][8] Epstein-Barr virus [9][10][11][12][13][14][15] Infective endocarditis [16][17][18][19][20][21][22] COVID-19 [23][24][25][26][27][28][29][30][31][32][33][34][35] Dengue virus [36] Mycoplasma pneumoniae [37,38] Malaria [39,40] Scrub typhus [41,42] Aspergillus pericarditis [43] Babesiosis [44] Malignancy including neoplasm and myeloproliferative diseases…”

Section: Causes Of Splenic Infarction Referencesmentioning

confidence: 99%

Clinical, Hematological, Biochemical and Radiological Characteristics for Patients With Splenic Infarction: Case Series With Literature Review

et al. 2023

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Background Splenic infarction is a frequently missed diagnosis in acute clinical conditions and is often under-diagnosed due to the lack of high-quality evidence on pathophysiology of splenic infarction. Due to the scarcity of such evidence, no consensus guidelines regarding the diagnostic approach and management of patients with splenic infarction exist. Most of published articles on splenic infarction are case reports and there was no systematic review on splenic infarction. Methods We conducted a retrospective analysis of all radiologically confirmed cases of splenic infarction patients with any history of admission at National Center for Global Health and Medicine Kohnodai Hospital, from 2014 to 2020. Further, to understand the pathophysiology that causes splenic infarction, we searched the literatures on splenic infarction. Results We found 18 patients with splenic infarction. The average age was 78 years, and about half of patients had abdominal pain; however, the other half did not have abdominal pain. One-third of patients with splenic infarction died. Leukocytosis with neutrophilia, a decrease of lymphocytes, anemia, hypoalbuminemia, and liver dysfunction were observed. Fibrinogen was decreased and D-dimer was remarkably elevated. Lactate dehydrogenase (LDH) and C-reactive protein (CRP) were remarkably increased. Six patients (33.3%) had cancer, four patients (22.2%) had atrial fibrillation, and four patients (22.2%) had infection. We found 466 case reports on splenic infarction published from 1975 to 2021. Recently, the number of case reports on splenic infarction due to infection, especially, coronavirus disease 2019 (COVID-19), has been remarkably increasing. Furthermore, we found that leukocytosis, a decrease of lymphocytes, elongated activated partial thromboplastin time, decrease of fibrinogen, liver dysfunction, elevation of LDH and blood urea nitrogen can be the prognosis predicting factors for patients with splenic infarction. Conclusion Our study elucidated clinical, hematological, biochemical and radiological characteristics for patients with splenic infarction. We newly found significant differences in blood cell counts, coagulation markers, transaminases, LDH and blood urea nitrogen between patients who died and those who survived, suggesting that these parameters can be the prognosis predicting factors for splenic infarction. Further, our systematic review on case reports about splenic infarction showed the etiology of splenic infarction and the trend of the causative diseases.

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“…Individuals with a healthy immune system might not even experience the symptoms of HCMV infection or rarely experience noticeable symptoms (Biswas & Kansal, 2023). They often have CMV mononucleosis which can lead to several symptoms including fatigue, muscle aches, headache, sore throat, and swollen lymph nodes (Ishii et al, 2019;Pakkiyaretnam et al, 2020). Individuals having congenital (present at birth) HCMV means that the virus passed from mother to the fetus and infants who got infected shortly after birth merely through breastfeeding can experience symptoms related to a number of diseases including anemia, jaundice, hepatomegaly, microcephaly, hearing loss, seizures, rash (Lin et The available antiviral therapies against HCMV-related diseases include ganciclovir, foscarnet, cidofovir, letermovir, maribavir, and other antibody therapies (Huntjens et al, 2023).…”

Section: Introductionmentioning

confidence: 99%

Identification of Novel Drug Targets and Immune Response Biomarkers in HCMV-Infected Hosts

Al-Maliki

Oohayyed

Mohameed³

et al. 2023

Preprint

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Human cytomegalovirus (HCMV) is a well known hallmark of increasing morbidity and mortality in humans with acquired impairment in innate and adaptive immunity indicating high seroprevalence rate of 83%. This study aims to identify novel drug targets as disease biomarkers in HCMV-infected hosts. Thereby datasets were collected from NCBI SRA Database and were further analyzed through RNA-seq pipeline to identify differentially expressed genes between HCMV-infected hosts and healthy individuals. Subsequently functional enrichment analysis of highly significant genes was performed through enrichR. RNA-seq analysis identified 1974 differentially expressed genes in HCMV-infected hosts including 678 over-modulated and 1028 down-modulated genes. Nevertheless, present DGE analysis study has reported novel drug targets including 5 protein-coding genes (RRAGD, SPINK1, NAP1L2, PKIG and LXN) and 2 pseudogenes (EEF1A1P38, WFDC21P). Additionally dysregulated genes have been found to be highly enriched in immune system related biological processes mainly Toll-like receptor signaling pathway, NOD-like receptor signaling pathway, PI3K-Akt signaling pathway, TNF signaling pathway and IL-17 signaling pathway indicating positive correlation between dysregulated immune-system mechanisms and HCMV replication. Hence this study has proposed novel therapeutic targets for early detection and treatment of HCMV infection that would positively influence public health. However wet laboratory explorations are required to ensure safety and efficacy of proposed drug targets.

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Cytomegalovirus-Associated Splenic Infarction in a Young Female Patient

Cited by 4 publications

References 6 publications

Salmonella paratyphi-induced splenic vein thrombosis

Salmonella paratyphi-induced splenic vein thrombosis

Clinical, Hematological, Biochemical and Radiological Characteristics for Patients With Splenic Infarction: Case Series With Literature Review

Identification of Novel Drug Targets and Immune Response Biomarkers in HCMV-Infected Hosts

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