title: Atypical presentation of cytomegalovirus infection in a liver transplant patient.
abstract: Cytomegalovirus (CMV) is the most common viral infection in solid organ transplant recipients. Symptomatic infection usually presents with fever, pneumonia, colitis, or cytopenia. We describe a case of symptomatic CMV infection in a liver transplant recipient presenting with atypical symptoms of only persistent nausea and vomiting, in the absence of classical symptoms and signs; thus, highlighting the importance of high index of suspicion of CMV in immunocompromised patients, keeping in mind the high morbidity and mortality associated with this disease.
authors.affiliation: Department of Gastroenterology and Hepatology, Sir Ganga Ram Hospital, New Delhi, India.
authors.forename: Naresh
authors.initials: N
authors.lastname: Bansal
authors.affiliation: Department of Gastroenterology and Hepatology, Sir Ganga Ram Hospital, New Delhi, India.
authors.forename: Anil
authors.initials: A
authors.lastname: Arora
authors.affiliation: Department of Liver Transplantation, Sir Ganga Ram Hospital, New Delhi, India.
authors.forename: Vinay
authors.initials: V
authors.lastname: Kumaran
authors.affiliation: Department of Liver Transplantation, Sir Ganga Ram Hospital, New Delhi, India.
authors.forename: Naimish
authors.initials: N
authors.lastname: Mehta
authors.affiliation: Department of Liver Transplantation, Sir Ganga Ram Hospital, New Delhi, India.
authors.forename: Vibha
authors.initials: V
authors.lastname: Varma
authors.affiliation: Department of Gastroenterology and Hepatology, Sir Ganga Ram Hospital, New Delhi, India.
authors.forename: Praveen
authors.initials: P
authors.lastname: Sharma
authors.affiliation: Department of Gastroenterology and Hepatology, Sir Ganga Ram Hospital, New Delhi, India.
authors.forename: Pankaj
authors.initials: P
authors.lastname: Tyagi
authors.affiliation: Department of Gastroenterology and Hepatology, Sir Ganga Ram Hospital, New Delhi, India.
authors.forename: Munish
authors.initials: M
authors.lastname: Sachdeva
authors.affiliation: Department of Gastroenterology and Hepatology, Sir Ganga Ram Hospital, New Delhi, India.
authors.forename: Ashish
authors.initials: A
authors.lastname: Kumar
keywords: ALT, alanine aminotransferase; ANA, anti-nuclear antibody; ASMA, antibody smooth muscle antigen; AST, aspartate aminotransferase; Atypical presentation; CMV, cytomegalovirus; EBV, Epstein-Barr virus; HBsAg, hepatitis B surface antigen; HEV, hepatitis E virus; INR, international normalized ratio; anti-HBc, antibody-hepatitis B core; anti-HCV, antibody-hepatitis C virus; anti-LKM, antibody-liver–kidney-microsomal antigen; cytomegalovirus; i.v., intravenous; immunosuppressed; liver transplant; transplantation