Abstract
Cytomegalovirus related serious complications in immunocompetent patients more frequently affect gastrointestinal tract causing colitis and central nervous system causing meningitis, encephalitis and transverse myelitis. Cytomegalovirus related thrombotic events are seen more commonly in immunocompromised patients. We describe a case of a 32-year-old healthy Caucasian male presenting with an acute febrile illness secondary to Cytomegalovirus with deep venous thrombosis and pulmonary embolism who was managed with antiviral therapy, anticoagulation and catheter directed thrombolysis.
Highlights
32-year-old healthy Caucasian male presented to the clinic after two weeks of a persistent febrile illness with 4 days of exertional dyspnea and left lower extremity swelling and pain
The fevers were initially thought to be secondary to thromboembolism but did not abate patient was on heparin infusion and further evaluation showed atypical lymphocytosis and viral serology for Epstein-Barr virus, Cytomegalovirus and Herpes virus was performed
Venous doppler of left lower extremity showed persistent venous thrombi and he received two sessions of intravascular catheter directed thrombolysis with tissue plasminogen activator, mechanical thrombectomy followed by low molecular heparin therapy and coumadin was discontinued. (Figure 1) shows the venogram of left lower extremity before catheter directed thrombolysis and (Figure 2) shows venogram after catheter directed thrombolysis with improved venous patency
Summary
32-year-old healthy Caucasian male presented to the clinic after two weeks of a persistent febrile illness with 4 days of exertional dyspnea and left lower extremity swelling and pain. The fevers were initially thought to be secondary to thromboembolism but did not abate patient was on heparin infusion and further evaluation showed atypical lymphocytosis and viral serology for Epstein-Barr virus, Cytomegalovirus and Herpes virus was performed. This revealed evidence of acute Cytomegalovirus (CMV) infection with elevated immunoglobulin M (IGM) of >5.0 and positive polymerase chain reaction (PCR) copies at 5,279 copies/mL. (Figure 1) shows the venogram of left lower extremity before catheter directed thrombolysis and (Figure 2) shows venogram after catheter directed thrombolysis with improved venous patency On enoxaparin therapy, he experienced complete resolution of symptoms and was able to restart coumadin.
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callMore From: Journal of Network Medicine and Targeted Therapies
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
