title: Cytomegalovirus oesophagitis following treatment with fludarabine for refractory lymphoplasmacytic lymphoma.
abstract: A 64-year-old man with a 2-week history of fatigue and fever presented to the medical admissions unit. He had a background of lymphoplasmacytic lymphoma and had recently completed a course of fludarabine-based chemotherapy. CT of the abdomen demonstrated an increase in spleen size and it was thought that his fevers were most likely due to disease recurrence or high-grade transformation. A bone marrow trephine was organised, which showed no evidence of lymphoma and positron emission tomography-CT demonstrated an area of increased avidity at the gastro-oesophageal junction. An oesophagogastroduodenoscopy was recommended, which revealed ulceration within the oesophagus and stomach. Biopsy of the lesions and immunohistochemistry confirmed a diagnosis of cytomegalovirus oesophagitis. He was treated with intravenous ganciclovir followed by oral valganciclovir for a total of 3&emsp14;weeks. His fever resolved and he was discharged home approximately 8&emsp14;weeks after he first presented.
authors: Milton Keynes General Hospital, Milton Keynes, UK. nicolapyatt@gmail.com
authors: Nicola
authors: N
authors: Pyatt
authors: Subir
authors: S
authors: Mitra
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use; D001706:Biopsy; D003586:Cytomegalovirus Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology*; D003937:Diagnosis, Differential; D016145:Endoscopy, Digestive System; D004941:Esophagitis / Q000175:diagnosis / Q000188:drug therapy* / Q000821:virology*; D015774:Ganciclovir / Q000031:analogs & derivatives / Q000627:therapeutic use; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D014057:Tomography, X-Ray Computed; D000077562:Valganciclovir; D014740:Vidarabine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D008258:Waldenstrom Macroglobulinemia / Q000188:drug therapy*
chemical_list: D000970:Antineoplastic Agents; D000998:Antiviral Agents; D014740:Vidarabine; D000077562:Valganciclovir; C024352:fludarabine; D015774:Ganciclovir