title: Pulmonary embolism and portal vein thrombosis in an immunocompetent adolescent with acute cytomegalovirus hepatitis.
abstract: Cytomegalovirus infection is usually asymptomatic or resembles infectious mononucleosis with fever, pharyngitis, arthralgias, lymphadenopathy, and atypical lymphocytosis. Even though primary CMV infection is usually self-limited in healthy individuals, significant complications can develop in immunocompromised patients. Venous or arterial thromboembolic phenomena are uncommon, yet very serious complications of CMV infection. Most published reports describe immunosupressed patients after organ transplantation or in the presence of HIV co-infection. However, thrombotic events in CMV infected immunocompetent individuals may occur. We describe the case of an immunocompetent adolescent with acute cytomegalovirus hepatitis that was complicated with pulmonary embolism and portal vein thrombosis. To our knowledge, this is the first reported case in which these two thrombotic phenomena occurred simultaneously in an adolescent with no obvious predisposing factors for thrombosis in the setting of an acute CMV infection.
authors.affiliation: Department of Internal Medicine, Lenox Hill Hospital, New York, NY, USA. dr_ladd25@yahoo.com
authors.forename: Antonio Mendoza
authors.initials: AM
authors.lastname: Ladd
authors.forename: Rakesh
authors.initials: R
authors.lastname: Goyal
authors.forename: Louis
authors.initials: L
authors.lastname: Rosainz
authors.forename: Peter
authors.initials: P
authors.lastname: Baiocco
authors.forename: Larry
authors.initials: L
authors.lastname: DiFabrizio
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D003586:Cytomegalovirus Infections / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D005260:Female; D015774:Ganciclovir / Q000031:analogs & derivatives / Q000627:therapeutic use; D006525:Hepatitis, Viral, Human / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D007121:Immunocompetence; D011169:Portal Vein / Q000473:pathology*; D011655:Pulmonary Embolism / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D000077562:Valganciclovir; D020246:Venous Thrombosis / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology
chemical_list: D000077562:Valganciclovir; D015774:Ganciclovir