Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2022 Dec 6;10(34):12605-12609.
doi: 10.12998/wjcc.v10.i34.12605.

Acute cytomegalovirus hepatitis in an immunocompetent patient: A case report

Jack P Wang  1 , Bou-Zenn Lin  1 , Chih-Lin Lin  1 , Kuan-Yang Chen  1 , Tsung-Jung Lin  2   3
Affiliations
Case Reports

Acute cytomegalovirus hepatitis in an immunocompetent patient: A case report

Jack P Wang et al. World J Clin Cases. .

Abstract

Background: Cytomegalovirus (CMV) infection is usually subclinical and asymptomatic in the healthy population, whereas severe complications occur in immunocompromised patients.

Case summary: In this case report, we described a rare case of acute CMV hepatitis in a 35-year-old male immunocompetent patient who presented with a history of week-long intermittent fever with nonspecific constitutional symptoms. Acute hepatitis was suspected according to the initial serological tests. After ruling out other etiologies, including viral hepatitis A, B, C, drug, alcohol, autoimmune, and Wilson disease, acute CMV hepatitis was diagnosed based on positive CMV IgM and DNA quantitative tests. Because there was no any local acute hepatitis E reported in Taiwan, so hepatitis E was not checked. The patient recovered both clinically and serologically with symptomatic management and without antiviral therapy within 12 days from the onset of symptom.

Conclusion: In conclusion, a diagnosis of CMV infection should be considered when nonspecific prodromal symptoms occur in acute hepatitis with an uncertain etiology. Antiviral therapy should not be used in immunocompetent patient who had no decompensation of the liver, such as this patient. Widely available noninvasive tests for CMV can facilitate early diagnosis if used appropriately. Harm-benefit analysis is essential before using antiviral therapy in immunocompetent patients.

Keywords: Acute hepatitis; Case report; Cytomegalovirus; Immunocompetent.

PubMed Disclaimer

Conflict of interest statement

Conflict-of-interest statement: All the authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The length of splenic long-axis was 11.4 cm on sonography.
Figure 2
Figure 2
Fever pattern in the initial 7 d of admission.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Crough T, Khanna R. Immunobiology of human cytomegalovirus: from bench to bedside. Clin Microbiol Rev. 2009;22:76–98, Table of Contents. - PMC - PubMed
    1. Bunchorntavakul C, Reddy KR. Epstein-Barr Virus and Cytomegalovirus Infections of the Liver. Gastroenterol Clin North Am. 2020;49:331–346. - PubMed
    1. Fakhreddine AY, Frenette CT, Konijeti GG. A Practical Review of Cytomegalovirus in Gastroenterology and Hepatology. Gastroenterol Res Pract. 2019;2019:6156581. - PMC - PubMed
    1. Eddleston M, Peacock S, Juniper M, Warrell DA. Severe cytomegalovirus infection in immunocompetent patients. Clin Infect Dis. 1997;24:52–56. - PubMed
    1. Noor A, Panwala A, Forouhar F, Wu GY. Hepatitis caused by herpes viruses: A review. J Dig Dis. 2018;19:446–455. - PubMed

Publication types