Multisystemic Disease in a Child and Successful Recovery With Antiviral Treatment

Area of Science:

• Pediatric Infectious Diseases
• Hepatology
• Virology

Background:

• Cytomegalovirus (CMV) infections are usually mild in immunocompetent individuals but can be severe in immunocompromised populations.
• Primary CMV infection can present atypically, posing diagnostic challenges.

Observation:

• A previously healthy seven-year-old girl developed severe primary CMV infection with multiorgan involvement, including hepatosplenomegaly, cholestasis, and bicytopenia.
• The diagnostic workup excluded other causes, and CMV infection was confirmed via serology and high viral load.

Findings:

• The patient experienced a prolonged disease course requiring intensive investigation.
• Intravenous ganciclovir treatment resulted in a complete recovery.

Implications:

• This case highlights CMV hepatitis as a differential diagnosis in immunocompetent children with unexplained hepatitis.
• Antiviral therapy may be beneficial in severe CMV cases in immunocompetent children, despite a lack of established guidelines.
• Increased clinical suspicion and timely intervention are crucial to prevent progression to liver failure.