Cavitary lung lesion in a patient with systemic lupus erythematosus: an unusual manifestation of cytomegalovirus pneumonitis.
We report a 35-year-old female patient with systemic lupus erythematosus (SLE). She was admitted due to deterioration of lupus nephritis and received treatment with a high dose of steroid and cyclosporine. Approximately 1 month after admission, the patient was also treated for cytomegalovirus (CMV) infection because she was found to have CMV antigenemia. Although a cavitary lesion was shown by chest computed tomography (CT), its cause could not be clarified by blood examination, smears or cultures, or by bronchoscopy. We considered that this lesion may have been caused by CMV pneumonitis because it was resolved during the treatment for CMV infection. It is known that CMV causes opportunistic infections in patients with collagen vascular diseases (CVD) who are receiving immunosuppressive therapy. However, it is extremely rare for a cavitary lesion to be formed as a result of CMV pneumonitis. Here we describe the details of this interesting case.
Katagiri
Akira
A
Department of Internal Medicine and Rheumatology, Juntendo University Shizuoka Hospital, 1129 Nagaoka, Izunokuni-shi, Shizuoka, Japan. VZM05164@nifty.com
Ando
Toshitaka
T
Kon
Takayuki
T
Yamada
Masato
M
Iida
Noboru
N
Takasaki
Yoshinari
Y
D000328:Adult; D016572:Cyclosporine / Q000009:adverse effects; D003586:Cytomegalovirus Infections / Q000150:complications* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000009:adverse effects; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000188:drug therapy; D009894:Opportunistic Infections / Q000000981:diagnostic imaging / Q000821:virology*; D011014:Pneumonia / Q000000981:diagnostic imaging / Q000821:virology*; D011859:Radiography; D013256:Steroids / Q000009:adverse effects
D007166:Immunosuppressive Agents; D013256:Steroids; D016572:Cyclosporine