title: Case report: severe cytomegalovirus primary infection in an immunocompetent adult with disseminated intravascular coagulation treated with valganciclovir.
abstract: BACKGROUND
  Disseminated intravascular coagulation (DIC) is a very rare complication of disseminated cytomegalovirus (CMV) infection. So far it is mainly described for immunocompromised patients.
  
  
  METHODS
  A 49-year-old immunocompetent Caucasian male presented with sudden onset of fever and DIC due to primary CMV infection, which was treated with Valganciclovir. CMV-specific IgG-avidity and epithelial cell-specific neutralisation-capacity developed five weeks after onset of symptoms. We describe the first case of an immunocompetent patient suffering from DIC due to a CMV primary infection successfully treated with Valganciclovir.
  
  
  CONCLUSIONS
  Primary CMV infection can occur accompanied with life threatening complications even in immunocompetent patients. Immediate treatment with Valganciclovir should be considered as an early treatment of choice in severe cases since specific neutralisation capacity might need several weeks to develop.
authors.affiliation: Department of Internal Medicine I, University Hospital of Tuebingen, D-72076 Tuebingen, Germany.
authors.forename: Niklas F
authors.initials: NF
authors.lastname: Müller
authors.affiliation: Institute of Medical Virology and Epidemiology of Viral Diseases, University Hospital of Tuebingen, D-72076 Tuebingen, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Schampera
authors.affiliation: Institute of Medical Virology and Epidemiology of Viral Diseases, University Hospital of Tuebingen, D-72076 Tuebingen, Germany.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Jahn
authors.affiliation: Department of Internal Medicine I, University Hospital of Tuebingen, D-72076 Tuebingen, Germany.
authors.forename: Nisar P
authors.initials: NP
authors.lastname: Malek
authors.affiliation: Department of Internal Medicine I, University Hospital of Tuebingen, D-72076 Tuebingen, Germany.
authors.forename: Christoph P
authors.initials: CP
authors.lastname: Berg
authors.affiliation: Institute of Medical Virology and Epidemiology of Viral Diseases, University Hospital of Tuebingen, D-72076 Tuebingen, Germany. klaus.hamprecht@med.uni-tuebingen.de.
authors.forename: Klaus
authors.initials: K
authors.lastname: Hamprecht
mesh_terms: D000998:Antiviral Agents / Q000008:administration & dosage*; D003587:Cytomegalovirus / Q000187:drug effects / Q000502:physiology*; D003586:Cytomegalovirus Infections / Q000150:complications* / Q000276:immunology / Q000382:microbiology; D004211:Disseminated Intravascular Coagulation / Q000188:drug therapy* / Q000209:etiology; D015774:Ganciclovir / Q000008:administration & dosage / Q000031:analogs & derivatives*; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D008875:Middle Aged; D000077562:Valganciclovir
chemical_list: D000998:Antiviral Agents; D000077562:Valganciclovir; D015774:Ganciclovir