Histologically specific skin lesions in disseminated cytomegalovirus infection

A diabetic renal transplant recipient developed fever, generalized rash, and genital ulcers which showed typical histologic changes of cytomegalovirus (CMV) infection in the dermal vascular endothelium. This infection was confirmed by rising serologic titer of specific antibody, positive viral cultures, and typical nuclear inclusion bodies in pulmonary and hepatic tissue at autopsy. Biopsy of the patient's skin lesions provided the opportunity for early diagnosis of this fatal systemic CMV infection. Two clinical patterns of specific cutaneous involvement in disseminated CMV infection are discussed.