Atteinte pulmonaire au cours d’une infection à Cytomegalovirus chez un adulte immunocompétent

Abstract

Cytomegalovirus (CMV) infection in the immunocompetent is generally silent or it may present as a mononucleosis like syndrome but, rarely, it can lead to symptomatic manifestations. An immunocompetent and previously healthy 43- year-old woman presented with fever, dyspnoea, liver cell necrosis and a mononucleosis syndrome. The CT scan showed diffuse ground-glass opacity. BAL and blood cultures were sterile. Urinary antigens (Legionella pneumophila, Streptococcus pneumoniae) and serology for atypical respiratory pathogens (Mycoplasma pneumoniae and Chlamydia sp.) were negative. A diagnosis of CMV pneumonia was established on serology (presence of anti-CMV IgM) and PCR detection of viral DNA in the serum. Without antiviral therapy, there was a favourable clinical outcome 1 week later and 1 month later the CT scan was normal. CMV infection can lead, exceptionally. to a hypoxic pneumonia in the immunocompetent host. Antiviral therapy should not be prescribed systematically.