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Published on: July 24, 2016
A butterfly shaped alveolar hemorrhage caused by cytomegalovirus
Aydin Ciledag1, Demet Karnak, Oya Kayacan
1Department of Chest Diseases, Ankara University School of Medicine, Ankara, Turkey.
Abstract:
Abstract. We report here a 35 year-old immunocompetent male, with a fulminantly lethal diffuse alveolar hemorrhage caused by CMV pneumonia. The patient was admitted with fever, rust colored sputum and exertional dyspnea. A chest x-ray revealed bilateral alveolar infiltration in a butterfly pattern. Bronchoalveolar lavage (BAL) was performed which revealed alveolar hemorrhage. Microscopic findings of the lavage fluid revealed large numbers of erythrocytes and hemosiderin-laden macrophages. The patient did not improve with empiric antibiotic treatment. High CMV IgG and IgM titers were found in the serum. The patient died from respiratory failure after detection of inclusion bodies on BAL before initiation of antiviral therapy.
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