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Cytomegalovirus ulceration of the oropharynx
P D French1, M A Birchall, J R Harris
1Middlesex Hospital, London.
Abstract:
Cytomegalovirus (CMV) is a common opportunistic infection in both iatrogenic and HIV-induced immunosuppression. The usual sites of involvement are the gastro-intestinal tract, retina and lung. We present three cases of CMV ulceration of the oropharynx. All three patients presented with symptoms localized to the oropharynx and in each case the diagnosis was only made on histological examination of ulcer biopsy specimens. The patients all responded well to ganciclovir treatment and at writing none have required maintenance therapy (7-11 months post diagnosis).
Insights
Cytomegalovirus (CMV) oropharyngeal ulcerations are rare but treatable in immunocompromised patients. Prompt diagnosis via biopsy and ganciclovir treatment led to successful outcomes without maintenance therapy in three cases.
Area of Science:
- Infectious Diseases
- Virology
- Immunology
Background:
- Cytomegalovirus (CMV) is a frequent opportunistic pathogen in immunocompromised individuals, typically affecting the gastrointestinal tract, retina, and lungs.
- Oropharyngeal involvement by CMV is less common but can present significant diagnostic challenges.
Observation:
- This study details three cases of immunocompromised patients presenting with symptoms exclusively localized to the oropharynx.
- Diagnosis in all cases was confirmed through histological examination of biopsy specimens from oropharyngeal ulcers.
Findings:
- All three patients with CMV oropharyngeal ulcerations demonstrated a positive response to ganciclovir therapy.
- No maintenance therapy was required for any of the patients during the follow-up period (7-11 months post-diagnosis).
Implications:
- Highlights the importance of considering CMV as a cause of oropharyngeal ulcers in immunosuppressed patients.
- Suggests that ganciclovir is an effective treatment for CMV oropharyngeal disease, potentially avoiding the need for long-term maintenance therapy.