title: A butterfly shaped alveolar hemorrhage caused by cytomegalovirus.
abstract: Abstract. We report here a 35 year-old immunocompetent male, with a fulminantly lethal diffuse alveolar hemorrhage caused by CMV pneumonia. The patient was admitted with fever, rust colored sputum and exertional dyspnea. A chest x-ray revealed bilateral alveolar infiltration in a butterfly pattern. Bronchoalveolar lavage (BAL) was performed which revealed alveolar hemorrhage. Microscopic findings of the lavage fluid revealed large numbers of erythrocytes and hemosiderin-laden macrophages. The patient did not improve with empiric antibiotic treatment. High CMV IgG and IgM titers were found in the serum. The patient died from respiratory failure after detection of inclusion bodies on BAL before initiation of antiviral therapy.
authors.affiliation: Department of Chest Diseases, Ankara University School of Medicine, Ankara, Turkey.
authors.forename: Aydin
authors.initials: A
authors.lastname: Ciledag
authors.forename: Demet
authors.initials: D
authors.lastname: Karnak
authors.forename: Oya
authors.initials: O
authors.lastname: Kayacan
mesh_terms: D000328:Adult; D001992:Bronchoalveolar Lavage Fluid / Q000821:virology; D003586:Cytomegalovirus Infections / Q000150:complications / Q000000981:diagnostic imaging*; D003588:Cytopathogenic Effect, Viral; D004801:Eosine Yellowish-(YS); D017809:Fatal Outcome; D006470:Hemorrhage / Q000000981:diagnostic imaging* / Q000821:virology*; D006801:Humans; D008297:Male; D008751:Methylene Blue; D011024:Pneumonia, Viral / Q000000981:diagnostic imaging*; D011650:Pulmonary Alveoli / Q000821:virology*; D011859:Radiography
chemical_list: C043260:May-Grunwald Giemsa; D008751:Methylene Blue; D004801:Eosine Yellowish-(YS)