Primary cytomegalovirus infection with accompanying Pneumocystis jiroveci pneumonia in a patient with large-vessel vasculitis.
A 70 year-old female patient presented with fever, nausea and dyspnea. She had been receiving immunosuppressive therapy with methotrexate and prednisone for large-vessel vasculitis. The patient was shown to have coexistent Pneumocystis jiroveci pneumonia and primary cytomegalovirus (CMV) infection with presumed CMV pneumonitis and colitis. To our knowledge, this is the first case report on the occurrence of combined primary cytomegalovirus and Pneumocystis jiroveci infection in a patient with vasculitis. It illustrates the importance of being aware of the possibility of combined opportunistic infections in patients with rheumatologic diseases.
Vetter
M
M
Department of Internal Medicine, University Hospital Basel, Petersgraben 4, 4031 Basel, Switzerland. vetterm@uhbs.ch
Battegay
M
M
Trendelenburg
M
M
D000368:Aged; D003587:Cytomegalovirus / Q000302:isolation & purification; D003586:Cytomegalovirus Infections / Q000150:complications* / Q000175:diagnosis / Q000382:microbiology; D005260:Female; D006801:Humans; D016867:Immunocompromised Host / Q000187:drug effects; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D008727:Methotrexate / Q000009:adverse effects / Q000627:therapeutic use; D009894:Opportunistic Infections / Q000150:complications / Q000382:microbiology / Q000821:virology; D045363:Pneumocystis carinii / Q000302:isolation & purification; D011020:Pneumonia, Pneumocystis / Q000150:complications* / Q000175:diagnosis / Q000821:virology; D011241:Prednisone / Q000009:adverse effects / Q000627:therapeutic use; D014657:Vasculitis / Q000188:drug therapy / Q000382:microbiology* / Q000821:virology
D007166:Immunosuppressive Agents; D011241:Prednisone; D008727:Methotrexate
Scand J Infect Dis. 2006;38(10):922-4
17008240
Crit Care Clin. 2002 Oct;18(4):931-56
12418448
Arch Pharm Res. 2002 Jun;25(3):215-28
12135090
J Med Virol. 1993;Suppl 1:106-11
8245874
Am J Respir Crit Care Med. 1995 Mar;151(3 Pt 1):795-9
7881673
Ann Trop Paediatr. 2007 Dec;27(4):243-52
18053340
Am J Respir Crit Care Med. 1997 May;155(5):1723-8
9154883
Chest. 1995 Aug;108(2):411-4
7634876
Curr Opin Rheumatol. 1998 Jan;10(1):38-44
9448988
Arthritis Rheum. 1974 Jan-Feb;17(1):1-10
4810662
Herpes. 2003 May;10(1):12-6
12749798
Med Microbiol Immunol. 2010 Feb;199(1):53-60
19949960
Clin Infect Dis. 2006 Nov 1;43(9):1143-51
17029132
J Am Geriatr Soc. 1997 Mar;45(3):334-7
9063280
Clin Infect Dis. 2003 Dec 15;37(12):1603-6
14689339
J Med Virol. 1992 Jul;37(3):170-3
1331304
Rheum Dis Clin North Am. 1997 May;23(2):259-75
9156392
J Infect Dis. 2002 Feb 1;185(3):273-82
11807708