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Case report
Primary cytomegalovirus infection with invasive disease in a patient with inflammatory bowel disease
  1. Jingyi Gong1,
  2. Eric Allan Meyerowitz2,
  3. Raymond A Isidro3 and
  4. Kenneth M Kaye4
  1. 1 Internal Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
  2. 2 Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts, USA
  3. 3 Anatomic Pathology, Brigham and Women's Hospital, Boston, Massachusetts, USA
  4. 4 Infectious Diseases, Brigham and Women's Hospital, Boston, Massachusetts, USA
  1. Correspondence to Dr Eric Allan Meyerowitz; emeyerowitz{at}mgh.harvard.edu

Abstract

A 37-year-old woman with a history of inflammatory bowel disease on mercaptopurine presented with a week of recurrent fever, headache, myalgias and mildly elevated serum transaminases and leucopenia. Her workup revealed primary cytomegalovirus (CMV) infection with atypical lymphocytosis, elevated viral load, positive IgM and negative IgG. Two weeks after her initial presentation, she developed odynophagia and diarrhoea prompting endoscopic evaluation with biopsies, which demonstrated CMV disease of the gastrointestinal tract. Her fever and systemic symptoms improved rapidly with initiation of intravenous ganciclovir. She was transitioned to and maintained on oral valganciclovir until two and half months after discharge when her symptoms and lab abnormalities had fully subsided.

  • inflammatory bowel disease
  • infection (gastroenterology)
  • infectious diseases
  • pathology
  • infections
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Footnotes

  • Contributors All authors contributed significantly to this work. JG and EAM drafted the manuscript primarily. RAI captured and annotated the figures and images found in the manuscript. KMK provided substantial edits to the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

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