Localized hepatic necrosis related to cytomegalovirus and Toxoplasma gondii

An unusual hepatic lesion due to both cytomegalovirus and Toxoplasma gondii was described in a patient with angio-immunoblastic lymphadenopathy treated by predonin. The lesion was a single well-defined area measuring 1.5 x 1.0 x 0.5 cm of confluent severe hepatic necrosis with multiple cytomegalic inclusion cells and numerous tokoplasmas. The remaining liver had no liver cell necrosis, inflammatory cell infiltration, or evidence of either cytomegalovirus infection or toxoplasmosis. These findings suggested us the possibility of symbiosis and synergism of cytomegalovirus and toxoplasma gondii in the liver. Additionally, this was the first demonstration of cytomegalovirus in liver cells by electron microscopy.