title: Cytomegalovirus hepatitis and pancreatitis in the immunocompetent.
abstract: BACKGROUND
  Cytomegalovirus (CMV) is a double-stranded DNA virus and a member of the Herpesviridae family. It is a lytic virus that causes a cytopathic effect in vitro and in vivo. CMV affects nearly all humans, with a 60%-100% seroprevalence worldwide, and in the immunocompetent it typically manifests as a mild and self-limiting mononucleosis syndrome. In immunocompromised patients, CMV has the ability to cause significant inflammation in many different organ systems.
  
  
  METHODS
  We report an unusual case of hepatitis and pancreatitis secondary to CMV in an immunocompetent patient. A 29-year-old male was admitted with elevated lipase, elevated aminotransferases, and epigastric pain after an acute viral prodrome. An initial CMV DNA polymerase chain reaction workup was positive, indicating acute or reactivated infection. Liver histology was consistent with CMV infection. Magnetic resonance cholangiopancreatography, endoscopic ultrasound, and intraoperative cholangiogram were not indicative of other etiologies. CMV viremia was successfully cleared with ganciclovir, and the patient experienced clinical and biochemical improvements.
  
  
  CONCLUSIONS
  Pancreatitis and hepatitis secondary to CMV are rare but should be considered in the workup of immunocompetent patients, especially in the presence of a recent viral-like illness.
authors.affiliation: Department of Medicine, University of Minnesota, Minneapolis, MN.
authors.forename: Aaron
authors.initials: A
authors.lastname: Chan
authors.affiliation: Department of Medicine, University of Minnesota, Minneapolis, MN.
authors.forename: Fateh
authors.initials: F
authors.lastname: Bazerbachi
authors.affiliation: Department of Medicine, University of Minnesota, Minneapolis, MN.
authors.forename: Brian
authors.initials: B
authors.lastname: Hanson
authors.affiliation: Department of Medicine, University of Minnesota, Minneapolis, MN.
authors.forename: M Chadi
authors.initials: MC
authors.lastname: Alraies
authors.affiliation: Department of Medicine, University of Minnesota, Minneapolis, MN.
authors.forename: Alisa
authors.initials: A
authors.lastname: Duran-Nelson
keywords: Cytomegalovirus; hepatitis; immunocompetence; pancreatitis