Disseminated cytomegalovirus infection presenting with acalculous cholecystitis and acute pancreatitis

Arch Pathol Lab Med. 1989 Nov;113(11):1287-9.


Disseminated cytomegalovirus (CMV) infection occurs predominantly in immunocompromised hosts. Symptomatic CMV cholecystitis and pancreatitis are quite rare, and, to our knowledge, there are no reports of these occurring simultaneously. We describe a patient with a history of chronic myelogenous leukemia (treated with chemotherapy) who presented with recurrent unexplained fevers and an acute abdomen. At surgery, cholecystitis and pancreatitis were found, and a cholecystectomy was performed. The patient developed disseminated intravascular coagulation, eventual sepsis, and multiorgan failure. At autopsy, widespread disseminated CMV infection was found, with CMV-associated foci of acute inflammation and necrosis in the pancreas and in the surgically resected gallbladder. A review of our autopsy files revealed only one renal transplant patient with CMV inclusions and chronic pancreatitis. No pancreatitis was seen in 27 patients with acquired immunodeficiency syndrome. Cytomegalovirus should be considered as a possible cause of pancreatitis and cholecystitis in immunocompromised patients.

MeSH terms

  • Acute Disease
  • Aged
  • Cholecystitis / pathology*
  • Cytomegalovirus Infections / pathology*
  • Diagnosis, Differential
  • Disseminated Intravascular Coagulation / pathology
  • Female
  • Humans
  • Pancreatitis / pathology*