Article

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: 2.55). 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: Primary acute cytomegalovirus infection in immunocompetent patients is common worldwide. Infection is most often asymptomatic or occurs sub-clinically with a self-limited mononucleosis-like syndrome. More rarely, the infection may lead to severe organ complications with pneumonia, myocarditis, pericarditis, colitis and hemolytic anemia. Recent cases of cytomegalovirus-associated thrombosis have also been reported sporadically in the medical literature. We report here a case of simultaneous myopericarditis and pulmonary embolism in a 30-year-old man with no medical history. The patient was not immunocompromised. We discuss the possible role of acute cytomegalovirus infection in the induction of vascular damage and review relevant cases in the literature. Thrombosis in patients with acute cytomegalovirus infection may be more frequent than is generally thought. Physicians need to be aware of the possible association between acute cytomegalovirus and thrombosis in immunocompetent patients, especially in the presence of severe systemic infection, as our case illustrates.
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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: 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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