Cytomegalovirus hepatitis and myopericarditis.

Department of Digestive disease, Hospital Donostia, Paseo Beguiristain S/N, 20014 San Sebastián (Gipúzcoa), Spain.
World Journal of Gastroenterology (Impact Factor: 2.43). 02/2007; 13(4):647-8.
Source: PubMed

ABSTRACT Cytomegalovirus (CMV) infection in inmunocompetent hosts generally is asymptomatic or may present as a mononucleosis syndrome but rarely can lead to severe organ complications. We report a case of simultaneous hepatic and pericardic CMV infection in a 36-year old immunocompetent man. He was admitted to coronary unit with fever, chest pain radiated to shoulders, changes on electrocardiogram with diffuse ST elevation and modest laboratory elevations in the MB fraction of creatine kinase (CK-MB) of 33.77 microg/L (0.1-6.73), serum cardiac troponin T of 0.904 ng/mL (0-0.4), creatine kinase of 454 U/L (20-195) and myoglobin of 480.4 microg/L (28-72). Routine laboratory test detected an elevation of aminotransferase level: alanine aminotransferase 1445 U/L, aspartate aminotransferase 601 U/L. We ruled out other causes of hepatitis with normal results except IgM CMV. The patient was diagnosed with myopericarditis and hepatitis caused by cytomegalovirus and started symptomatic treatment with salicylic acid. In few days the laboratory findings became normal and the patient was discharged.

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    ABSTRACT: Background Hepatitis is a descriptive term given for any inflammation of the liver. It can be characterized as inflammatory cells infiltrating normal hepatic parenchyma, which destroys their ability to perform normal physiologic functions. Hepatitis is a common disorder in immunocompetent populations, mainly attributed to viruses, alcohol, drugs, or autoimmune causes. Case Report Cytomegalovirus is a virus mostly affecting immunocompromised patients, resulting in infectious mononucleosis-like symptoms as well as hepatitis in liver transplant patients, but is generally benign in immunocompetent hosts. This report presents an unusual case of hepatitis caused by Cytomegalovirus in an immunocompetent patient with previous Herpes Simplex virus infection. A 20-year-old African-American woman presenting with intermittent subjective fevers and chills, sore throat, non-productive cough, and decreased appetite 1 month ago was diagnosed with a case of Cytomegalovirus-induced hepatitis. Conclusions This report clearly emphasizes the need for investigation of other disease entities such as Cytomegalovirus as a potential cause of hepatitis in an immunocompetent patient after more common causes of hepatitis have been ruled out.
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    ABSTRACT: We report a case of fulminant myocarditis after a primary cytomegalovirus infection, in a previously healthy 72-year-old woman. The infection underwent clinical and immunologic resolution consequent to treatment with oral valganciclovir. In an immunocompetent host, the primary cytomegalovirus infection is usually asymptomatic or manifests itself as a heterophile-negative mononucleosis-like syndrome. Cytomegalovirus myocarditis is uncommon in immunocompetent patients. After presenting our case, we review the literature on cytomegalovirus myocarditis in immunocompetent individuals.
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    ABSTRACT: This study aims to analyze and evaluate the clinic and demographic features of immunocompetent children that have been diagnosed with cytomegalovirus (CMV) infection. The data of children diagnosed with CMV infection between January 2005 and December 2010 and their follow-ups for 2 years were retrospectively evaluated. Ninety-eight patients were included, and the median age at admission was 5.6 months (5 days-36 months). 54.1 % was male. The diagnosis of CMV infection was performed by measurement of serum anti-CMV specific Ig M and IgG titers and PCR method in blood and/or urine. In 3.06 % of the patients, congenital infection was detected, whereas possible congenital infection was observed in 36.7 % of the patients. Furthermore, 44 patients (44.8 %) were detected to have perinatal infection while postnatal infection was spotted in 15.3 % of the patients. The common presenting manifestations were prolonged jaundice, diarrhea, vomiting, abdominal distension, skin eruption, and seizure. And the most common physical examination findings were hepatosplenomegaly, microcephaly, jaundice, and petechia. The mainstream laboratory results were elevated transaminases (50 %), anemia (30.6 %), leukocytosis (27.5 %), and thrombocytopenia (18.3 %). There were intracranial calcification in 5.1 % and eye findings in 5.1 %. On follow-up of patients, complete improvement (59.1 %), neuromotor developmental delay (11.2 %), epilepsy (10.2 %), hearing loss (3.06 %), hemolytic anemia (2.04 %), and growth retardation (1.02 %) were detected. CMV infection is a significant disease both in congenital and perinatal period. It must be considered that diagnosed patients need to be monitored for a long time with special attention to their neurodevelopmental follow-ups. What is Known: • Manifestations, follow-up findings, and treatment approaches of CMV infection in immunocompetent individuals have not been extensively revised and have received less attention in the literature. What is New: • This study is intended for evaluation of the clinical and demographic characteristics and laboratory findings of immunocompetent children with CMV infection in with a broad series of patients.
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