A case of severe acute pancreatitis associated with a systemic cytomegalovirus infection

Abstract

A healthy 50-year-old man complained of acute abdominal pain after heavy drinking. An abdominal enhanced CT scan demonstrated an enlarged heterogeneous pancreas with fluid collection. The patient was diagnosed with severe acute pancreatitis (SAP) and treated with continuous arterial infusion of nafamostat mesilate, antibiotics, continuous hemodiafiltration and artificial ventilation. Pancreatic necrosectomy and ileostomy were performed because of a giant peripancreatic and retroperitoneal abscess and sepsis. Despite surgical treatment, complications ensued from perforations to the colon and stomach, and intra-abdominal bleeding. He died on the 70th day after his admission. Autopsy results revealed that he had SAP accompanied with a systemic cytomegalovirus (CMV) infection, characterized with a high presence of CMV inclusion bodies in the lung, esophagus, stomach, colon and pancreas. It is necessary to consider the possibility of complications from CMV infection when treating patients with SAP.