Abstract
Cytomegalovirus (CMV) is a double-stranded DNA virus of the Herpesviridae family that causes various forms of infection in humans. We herein report the case of a healthy middle-aged adult who developed CMV-associated infectious mononucleosis-like syndrome (CMV-IM) complicated with splenic infarction and gastroenteritis. The patient, a 44-year-old Japanese woman, underwent a thorough examination because of a fever that had lasted three weeks. Our laboratory detected atypical lymphocytes and an elevated transaminase level. Contrast-enhanced computed tomography scan revealed a splenic infarction. Serum CMV antigen was positive and CMV IgM showed an increasing trend after the onset, leading to the diagnosis of primary CMV infection. Moreover, endoscopy revealed multiple ulcers in the gastric antrum and the terminal ileum, and pathological findings showed nuclear inclusion bodies, indicating the development of CMV gastroenteritis. The patient’ s fever subsided with two weeks of valganciclovir, and the laboratory abnormalities recovered. CMV-IM usually resolves spontaneously in immunocompetent individuals, and antiviral treatment is not recommended. Little evidence is available regarding the necessity of antiviral or anticoagulant therapies for patients with CMV-IM complicated with thrombosis and gastroenteritis. Future study will be need to clarify the treatment indications after comprehensive evaluation of such patients.
