Reactivation versus primary CMV infection after splenectomy in immunocompetent patients

Dig Dis Sci. 2007 Dec;52(12):3477-9. doi: 10.1007/s10620-006-9712-1. Epub 2007 Apr 12.

Abstract

Acute CMV infection in the immunocompetent host is usually asymptomatic or produces only mild symptoms. CMV infection in immunocompromized patients, especially transplant recipients and those infected with HIV, is a result of profound lymphopenia or dysfunction of CD4+/CD8+ cells and can cause substantial rates of complication and death. We present a case of CMV infection in a previously healthy man who just had splenectomy for blunt trauma: a short incubation of the CMV disease, a strongly positive CMV antigenemia, severity of the disease including prominent lymphocytosis, massive hepatic sinusoidal infiltration, and retinitis. Splenectomy changed the immunological defense against the virus and brought the infection to nearly fulminant scale.

Publication types

  • Case Reports

MeSH terms

  • Abdominal Injuries / surgery
  • Adult
  • Antibodies, Viral / immunology*
  • Antiviral Agents / administration & dosage
  • CD4-CD8 Ratio
  • Cytomegalovirus / genetics
  • Cytomegalovirus / immunology*
  • Cytomegalovirus Infections / drug therapy
  • Cytomegalovirus Infections / etiology*
  • Cytomegalovirus Infections / virology
  • DNA, Viral / genetics
  • Follow-Up Studies
  • Ganciclovir / administration & dosage
  • Humans
  • Immunocompetence*
  • Injections, Intravenous
  • Male
  • Postoperative Complications
  • Spleen / injuries
  • Spleen / surgery
  • Splenectomy / adverse effects*
  • Wounds, Nonpenetrating / surgery

Substances

  • Antibodies, Viral
  • Antiviral Agents
  • DNA, Viral
  • Ganciclovir