PT - JOURNAL ARTICLE AU - Jingyi Gong AU - Eric Allan Meyerowitz AU - Raymond A Isidro AU - Kenneth M Kaye TI - Primary cytomegalovirus infection with invasive disease in a patient with inflammatory bowel disease AID - 10.1136/bcr-2019-230056 DP - 2019 Sep 01 TA - BMJ Case Reports PG - e230056 VI - 12 IP - 9 4099 - http://casereports.bmj.com/content/12/9/e230056.short 4100 - http://casereports.bmj.com/content/12/9/e230056.full SO - BMJ Case Reports2019 Sep 01; 12 AB - 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.