RT Journal Article
SR Electronic
T1 CMV pneumonitis in a patient with Crohn’s disease taking azathioprine
JF BMJ Case Reports
JO BMJ Case Reports
FD BMJ Publishing Group Ltd
SP e241256
DO 10.1136/bcr-2020-241256
VO 14
IS 4
A1 Timothy Zef Hawthorne
A1 Rachel Shellien
A1 Lucy Chambers
A1 Graham Devereux
YR 2021
UL http://casereports.bmj.com/content/14/4/e241256.abstract
AB This case report discusses the rare presentation of cytomegalovirus (CMV) pneumonitis in a young patient with moderately severe Crohn’s disease managed with low dose azathioprine. CMV pneumonitis was initially suspected on CT chest images and confirmed by PCR for CMV. She was treated with intravenous ganciclovir and later stepped down to oral valganciclovir. Although this patient had a prolonged and complicated hospital admission, a good clinical outcome was achieved. CMV infection was raised as an early differential and antiviral treatment was started without delay. This case study, therefore, makes the case for increased awareness of the possibility of, and recognition of CMV pneumonitis among healthcare professionals as a way of preventing significant morbidity and mortality. It also raises awareness of checking for slow metabolisers of azathioprine before initiation to look for individuals who may be at increased risk of azathioprine’s adverse effects.