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Liver Abscess caused by Cytomegalovirus in a Patient with Acquired Immunodeficiency Syndrome
Jin Young Lee1, Jong Woo Park2, Ji Young Park3
1Department of Internal Medicine, Kosin Medical College, Busan, Korea.
Abstract:
Cytomegalovirus (CMV) causes severe infection in immunocompromised patients, especially those with acquired immunodeficiency syndrome (AIDS), those who have undergone organ transplantation, and/or those who are being treated with steroids. In patients with AIDS, CMV is the most common pathogen that causes opportunistic infections. Here, we present a case of liver abscess due to CMV in a 58-year-old man diagnosed with AIDS. At the time of the study, his CD4 T lymphocyte count was 39 cells/mm3, and his human immunodeficiency virus (HIV) ribonucleic acid (RNA) level was 411,000 copies/mL. Upon presentation, he complained of upper abdominal pain. Ultrasonography-guided percutaneous drainage of the liver abscess was performed, and polymerase chain reaction analysis of the drained pus was positive for CMV. He was treated with intravenous ganciclovir, after which he recovered fully. In conclusion, our patient represents, to our knowledge, the first described case of liver abscess caused by CMV in an AIDS patient, which was probably facilitated by severe immunodeficiency.
Insights
Cytomegalovirus (CMV) can cause severe opportunistic infections in individuals with acquired immunodeficiency syndrome (AIDS). This case highlights a rare liver abscess caused by CMV in an AIDS patient, successfully treated with ganciclovir.
Area of Science:
- Infectious Diseases
- Hepatology
- Immunology
Background:
- Cytomegalovirus (CMV) is a significant opportunistic pathogen in immunocompromised individuals, particularly those with acquired immunodeficiency syndrome (AIDS).
- CMV infections are common in AIDS patients, often leading to severe complications.
- Liver abscesses are typically caused by bacterial infections, with viral causes being rare.
Observation:
- A 58-year-old male patient diagnosed with AIDS presented with upper abdominal pain.
- The patient had a low CD4 T lymphocyte count (39 cells/mm³) and a high human immunodeficiency virus (HIV) RNA level (411,000 copies/mL).
- Ultrasonography-guided percutaneous drainage of a liver abscess was performed.
Findings:
- Polymerase chain reaction (PCR) analysis of the drained liver abscess pus confirmed the presence of Cytomegalovirus (CMV).
- The patient was treated with intravenous ganciclovir, an antiviral medication.
- Complete recovery was observed following the ganciclovir treatment.
Implications:
- This case represents the first documented instance of a liver abscess caused by CMV in an acquired immunodeficiency syndrome (AIDS) patient.
- Severe immunodeficiency in AIDS patients likely predisposed this individual to CMV liver abscess formation.
- The findings underscore the importance of considering CMV as a potential cause of liver abscess in severely immunocompromised patients, especially those with AIDS.
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