Fatal Massive Hepatic Necrosis in Cytomegalovirus Mononucleosis

Severe Cytomegalovirus Hepatitis in a Pregnant Woman Treated with Ganciclovir

“…Liver disease was observed in 17 patients. Severe hepatitis was present in a few cases (3,4). Three of the 34 cases reviewed by Eddleston et al were of pregnant women, 2 of whom died.…”

Recurrent ascites in an infant with perinatally acquired cytomegalovirus infection

“…This mild to moderate form of hepatitis is self limited and usually resolves during the first 4-6 months of life [3]. Other less common hepatic manifestations of CMV are noncirrhotic portal fibrosis with portal hypertension, granulomatous hepatitis and massive hepatic necrosis reported in adults [1,2,6]. Neonatal cytomegalic inclusion disease usually does not lead to chronic liver disease [4].…”

“…The differential diagnosis of neonatal ascites reviewed by Machin(5), includes urinary tract obstruction, chylous ascites, hepatic causes such as biliary atresia and portal dysplasia, intestinal perforation, ovarian cyst, inborn errors of metabolism and infectious causes such as syphylis, toxoplasmosis and CMV (6). Besides CMV infection, the other aetiological possibilities for ascites in our patient were excluded by radiological, ultrasound, serological and metabolic workup and examination of the ascitic fluid.…”

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“…As such, OLTx is rarely possible and is not indicated unless high dose intravenous acyclovir therapy, as used for the treatment of herpes hepatitis, fails to resolve the disease process (33). C) Cytomegalovirus Hepatitis (CMV) As is the case with the preceding two opportunistic viruses, CMV hepatitis can occur and present as fulminant hepatic failure (38). High fever, leucopenia and encephalopathy signal the onset of CMV fulminant hepatitis.…”