Acute cervicitis and vulvovaginitis may be associated with Cytomegalovirus

BMJ Case Rep. 2013 Apr 19:2013:bcr2013008884. doi: 10.1136/bcr-2013-008884.

Abstract

Cytomegalovirus (CMV) infection in immunocompetent hosts is generally asymptomatic or may present as a mononucleosic syndrome. Its association with acute cervicitis and vulvovaginitis has rarely been reported. A 24-year-old woman presented with pelvic pain, vulvodynia, abnormal vaginal discharge, burning with urination, fatigue, fever, vomiting and diarrhoea. The vulva and cervix were red with vesicular lesions on the cervix. Genital herpes simplex infection (HSV) was suspected and valacyclovir was given orally. However, serial viral cultures performed 7 weeks apart did not isolate HSV as suspected, but CMV was confirmed by immunofluorescence and early antigen research. Blood tests confirmed an acute CMV infection. Typical inclusions were found at histology. Symptoms resolved slowly with persistence of cervical lesions at 7 weeks from diagnosis. The frequency of CMV genital infection is probably underestimated. The infection is not always asymptomatic and might be confused with genital HSV infection. The clinical course is longer.

Publication types

  • Case Reports

MeSH terms

  • Antiviral Agents / therapeutic use
  • Cytomegalovirus Infections / diagnosis*
  • Cytomegalovirus Infections / drug therapy
  • Diagnosis, Differential
  • Female
  • Humans
  • Uterine Cervicitis / drug therapy
  • Uterine Cervicitis / virology*
  • Vulvovaginitis / drug therapy
  • Vulvovaginitis / virology*
  • Young Adult

Substances

  • Antiviral Agents