Nonspecific radiographic manifestations of cytomegalovirus infection in 4 HIV-positive adults – diagnosis through transbronchial biopsy

Matthew Goodier,Grace Rubin

doi:10.4102/sajhivmed.v12i1.210

Abstract

Case Study

Highlights

Case 1 A 45-year-old man with a history of previous tuberculosis (TB) infection presented with a cough and chest pain
Case 2 A 43-year-old woman with no history of TB or TB contacts presented with a cough and haemoptysis, loss of weight, low fever and rigors
Transbronchial biopsy in all patients demonstrated alveolar tissue containing CMV with nuclear and cytoplasmic inclusions (Fig. 3). This was accompanied by alveolitis and an associated inflammatory cell infiltrate

Summary

Introduction

Case 1 A 45-year-old man with a history of previous tuberculosis (TB) infection presented with a cough and chest pain. The white cell count (WCC) was 6.4×109/l, and sputum results and blood cultures were negative. Bronchoscopic biopsy confirmed the diagnosis of both CMV and PJP infections. Treatment for TB and PJP was started, but the patient showed no clinical improvement Bronchoscopic biopsy confirmed both CMV and pneumocystis pneumonia (PCP). Case 4 A 29-year-old woman presented with a cough, chest pain, loss of weight and shortness of breath. On the CXR there were bilateral, diffuse, reticular and airspace shadows with no effusions (Fig. 2, c) Both TB and PJP were considered in the differential diagnosis. Transbronchial biopsy in all patients demonstrated alveolar tissue containing CMV with nuclear and cytoplasmic inclusions (Fig. 3). This was accompanied by alveolitis and an associated inflammatory cell infiltrate

Discussion

Conclusion