Uncommon Presentation of Cytomegalovirus Encephalitis in an Immunocompetent Host: A Case Report

Abstract

Background: Cytomegalovirus (CMV) encephalitis is rare in immunocompetent individuals and often lacks typical imaging or laboratory findings, making diagnosis challenging.

Case presentation: We report a 68-year-old immunocompetent male with progressive encephalopathy and fever. Magnetic resonance imaging (MRI) and cerebrospinal fluid (CSF) studies were unremarkable, but CMV deoxyribonucleic acid (DNA) was detected via polymerase chain reaction (PCR) in CSF and blood. The patient responded well to a 14-day course of intravenous ganciclovir and made a full recovery.

Conclusion: CMV encephalitis should be considered in cases of unexplained encephalitis, even in immunocompetent hosts with normal imaging. Early PCR testing and antiviral treatment are key to favorable outcomes.