J Rheum Dis.  2015 Dec;22(6):387-390. 10.4078/jrd.2015.22.6.387.

Cavitary Lung Lesion in a Patient with Systemic Lupus Erythematosus: An Unusual Manifestation of Cytomegalovirus Pneumonia

• Park S
• Jang HJ
• Kim YW
• Park BS
• Kim HK
• Song JW
• Kim YM
• Jin K

• KMID: 2222814
• DOI: http://doi.org/10.4078/jrd.2015.22.6.387

Abstract

Cytomegalovirus (CMV), a member of the human herpesvirus group, causes severe disease in immunocompromised patients. In particular, CMV pneumonia can be a life-threatening disease to patients taking immunosuppressive drugs. The radiographic manifestations of CMV are variable and may consist of reticular or reticulonodular patterns, ground-glass opacities, air-space consolidations, or mixed patterns. A cavitary lesion in pneumonia associated with CMV infection is extremely rare. Herein we report on a case of CMV pneumonia which presented with a cavitary lesion and was treated successfully in a systemic lupus erythematosus patient who was taking immunosuppressive drugs.

Keyword

Pneumonia; Cytomegalovirus; Systemic lupus erythematosus

MeSH Terms

Cytomegalovirus*
Humans
Immunocompromised Host
Lung*
Lupus Erythematosus, Systemic*
Pneumonia*

Figure

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  Figure 1. Chest plain radiography shows a large cavitary mass like lesion in the right upper lung field (arrow).

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  Figure 2. Chest computed tomography with coronal reformatted image shows a large cavitary mass like lesion in the right upper lobe.

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  Figure 3. (A) The irregularly dilated alveoli showed mononuclear inflammatory cell infiltration in the interstitium and multiple intranuclear cytomegalovirus inclusions in the alveolar pneumonocytes (arrows) (H&E, ×400). (B) Immunohistochemistry (IHC) with an-ti-cytomegalovirus (CMV) confirmed the CMV infected pneumonocytes with intranuclear inclusions (arrows) (IHC, ×400).

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  Figure 4. After treatment of cytomegalovirus pneumonia, the size of cavitary lung lesion was decreased.

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