title: Cytomegalovirus pneumonitis in a patient with nephrotic syndrome receiving low-dose prednisolone and pulmonary tuberculosis.
abstract: Cytomegalovirus pneumonitis in a patient with pulmonary tuberculosis has been rarely reported. We report on a patient with nephrotic syndrome and documented pulmonary tuberculosis who received antituberculous therapy. Chest radiography showed a newly developed patch, and he underwent high-resolution computed tomography examination of the chest and open lung biopsy. Histopathologic studies of the lung showed interstitial pneumonitis, which had focal syncytial pneumocytes with focal nuclei atypia, inclusion bodies, and prominent eosinophilic nucleoli. Polymerase chain reactions for cytomegalovirus were positive in the sputum and biopsy specimen. The patient recovered well with ganciclovir treatment. When new pulmonary infiltrates develop in patients with pulmonary tuberculosis during antituberculous therapy, cytomegalovirus pneumonitis should not be overlooked.
authors.affiliation: Division of Infectious Disease and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Te-Yu
authors.initials: TY
authors.lastname: Lin
authors.forename: Yuen-Hua
authors.initials: YH
authors.lastname: Ni
authors.forename: Feng-Yee
authors.initials: FY
authors.lastname: Chang
authors.forename: Ning-Chi
authors.initials: NC
authors.lastname: Wang
mesh_terms: D000904:Antibiotics, Antitubercular / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use; D003587:Cytomegalovirus / Q000472:pathogenicity*; D003586:Cytomegalovirus Infections / Q000175:diagnosis / Q000188:drug therapy / Q000821:virology*; D015774:Ganciclovir / Q000627:therapeutic use; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008168:Lung / Q000382:microbiology / Q000473:pathology / Q000821:virology; D008297:Male; D008875:Middle Aged; D009404:Nephrotic Syndrome / Q000150:complications* / Q000188:drug therapy; D011014:Pneumonia / Q000175:diagnosis / Q000188:drug therapy / Q000821:virology*; D011239:Prednisolone / Q000627:therapeutic use; D014397:Tuberculosis, Pulmonary / Q000150:complications* / Q000188:drug therapy
chemical_list: D000904:Antibiotics, Antitubercular; D000998:Antiviral Agents; D005938:Glucocorticoids; D011239:Prednisolone; D015774:Ganciclovir