Acute superior mesenteric vein thrombosis in the setting of cytomegalovirus mononucleosis: a case report and review of the literature

Lancet Infect Dis. 2021 Jul;21(7):e202-e207. doi: 10.1016/S1473-3099(20)30782-9. Epub 2021 May 14.

Abstract

Cytomegalovirus is a viral genus of the overarching family Herpesviridae, and is of particular importance because of its relevance to human disease. This association is predominantly due to human cytomegalovirus, a well-studied pathogen. In addition to the mononucleosis syndrome that can occur during acute cytomegalovirus viraemia, this virion has been recurrently implicated as a provoking factor for thromboembolic disease in the published scientific literature. As physicians increasingly forgo extensive laboratory investigation in the setting of clinical hypercoagulability, it has also become evident that in some circumstances whether or not a particular investigation alters clinical management is not necessarily the only important question. Viraemia as a provoking factor for thrombosis stands as such an example. The aim of this Grand Round is to further explore the role of cytomegalovirus as it pertains to thromboembolic disease, especially in the present era of viral-associated thromboembolism.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Abdominal Pain / etiology
  • Acute Disease*
  • Adult
  • Anticoagulants / therapeutic use*
  • Cytomegalovirus Infections / complications*
  • Factor Xa Inhibitors / therapeutic use
  • Female
  • Fever / etiology
  • Heparin / therapeutic use*
  • Herpesvirus 4, Human* / isolation & purification
  • Humans
  • Lymphocytosis / etiology
  • Mesenteric Vascular Occlusion / virology*
  • Mesenteric Veins
  • Rivaroxaban / therapeutic use
  • Venous Thrombosis / diagnostic imaging*
  • Venous Thrombosis / drug therapy*
  • Venous Thrombosis / virology
  • Viremia

Substances

  • Anticoagulants
  • Factor Xa Inhibitors
  • Heparin
  • Rivaroxaban