Tuberc Respir Dis.  2008 Apr;64(4):309-313. 10.4046/trd.2008.64.4.309.

A Case of Diffuse Alveolar Hemorrhage Associated with Cytomegalovirus Pneumonia

• Cho YD
• Choi HS
• Park MJ

• KMID: 1970183
• DOI: http://doi.org/10.4046/trd.2008.64.4.309

Abstract

Cytomegalovirus (CMV) pneumonia is a serious opportunistic infection in an immunocompromised host such as an AIDS patient or transplant recipient undergoing immunosuppressive therapy. Diffuse alveolar hemorrhage (DAH) is a relatively uncommon condition and it occurs most often in patients with systemic autoimmune disease. However, various types of infectious pneumonia with Mycoplsma hominis, Stenotrophomonas maltophilia and Pneumocystis jirovecii have been reported to be associated with the development of DAH. The association of CMV infection with the development of DAH has rarely been reported. We experienced a case of DAH associated CMV pneumonia and the patient was successfully treated with the use of antiviral agents and steroids.

Keyword

Cytomegalovirus infections; Diffuse alveolar hemorrhage

MeSH Terms

Antiviral Agents
Autoimmune Diseases
Cytomegalovirus
Cytomegalovirus Infections
Hemorrhage
Humans
Immunocompromised Host
Opportunistic Infections
Pneumocystis jirovecii
Pneumonia
Stenotrophomonas maltophilia
Steroids
Antiviral Agents
Steroids

Figure

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  Figure 1 The Result of CMV-PCR. 1: molecular marker; 2: positive control; 3~5: negative control; 6: patient blood sample; 7: patient BAL sample; 8~10: negative control.

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  Figure 2 Chest X-ray showed diffuse bilateral alveolar infiltrates in both lung fields.

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  Figure 3 HRCT showed bilateral ground glass opacities and interlobular septal thickening in both lung fields and pleural effusion especially in left side.

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  Figure 4 Bronchoalveolar lavage fluid showed hemosiderin laden macrophages (Prussian-Blue staining, ×200).

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  Figure 5 Chest X-ray showed improvement after the treatment with ganciclovir and steroid.

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