Cytomegalovirus infection-associated fulminant hepatitis in an immunocompetent adult requiring emergency living-donor liver transplantation: report of a case.
Human cytomegalovirus (CMV) infection is usually self-limiting in healthy adults, but it can lead to significant complications. This report presents the case of an immunocompetent adult with fulminant hepatitis caused by a CMV infection requiring emergency living-donor liver transplantation. A 39-year-old female with persistent fever for 6 weeks was referred for fulminant hepatitis, but the underlying etiology was not identified. Rapid deterioration of consciousness led to an emergency living-donor liver transplant using a modified right lobe graft. She showed increasing CMV antigenemia after surgery and the explant liver pathology showed massive hepatic necrosis with positive staining for CMV protein. Treatment with ganciclovir improved the graft liver function and her general condition recovered. This report presents a rare case of CMV-associated fulminant hepatitis which led to emergency liver transplantation. Although CMV is rare, it should be included in the differential diagnosis of patients with severe hepatitis, even immunocompetent patients, after other more common etiologies have been excluded.
Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul 138-736, Korea.
Young-Dong
YD
Yu
Gil-Chun
GC
Park
Pyoung-Jae
PJ
Park
Young-Il
YI
Choi
Shin
S
Hwang
Gi-Won
GW
Song
Dong-Hwan
DH
Jung
Chul-Soo
CS
Ahn
Ki-Hun
KH
Kim
Deog-Bok
DB
Moon
Tae-Yong
TY
Ha
Sung-Gyu
SG
Lee
D000328:Adult; D003586:Cytomegalovirus Infections / Q000175:diagnosis / Q000276:immunology / Q000601:surgery*; D004630:Emergencies; D005260:Female; D006525:Hepatitis, Viral, Human / Q000175:diagnosis / Q000276:immunology / Q000601:surgery*; D006801:Humans; D007121:Immunocompetence; D016031:Liver Transplantation; D019520:Living Donors