Infection by human cytomegalovirus associated with chronic hematospermia

Hematospermia, or blood in the ejaculate, is not an infrequent urologic condition most often occurring without recognizable physical dysfunction. It is regarded as benign and self-resolving. In its chronic form, however, it may manifest periodic recurrences or persistence for months to years. We had opportunity to follow the course of cytomegalovirus (CMV) infection in a patient experiencing both chronic hematospermia and CMV mononucleosis. The level of virus output in urine (representing systemic CMV infection) remained constant over a period of forty-four weeks during and after convalescence from the mononucleosis syndrome. However, virus isolation from semen (representing localized CMV infection) appeared to parallel the course of and concomitantly terminate with the resolution of the urologic condition. The concentration and temporal association of CMV with the course of chronic hematospermia is suggestive of a causative role in this genital pathology.