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Toxic epidermal necrolysis associated with severe cytomegalovirus infection in a patient on regular hemodialysis

Primary illness with cytomegalovirus leads to latent infection with possible reactivations especially in the immunocompromised patients. Toxic epidermal necrolysis is an immune mediated cytotoxic reaction. A fifty years old female diabetic hypertensive patient with end stage renal disease was admitt...

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Autores principales: Khalaf, Dina, Toema, Bassem, Dabbour, Nidal, Jehani, Fathi
Formato: Texto
Lenguaje:English
Publicado: Università Cattolica del Sacro Cuore 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3103263/
https://www.ncbi.nlm.nih.gov/pubmed/21625308
http://dx.doi.org/10.4084/MJHID.2011.004
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author Khalaf, Dina
Toema, Bassem
Dabbour, Nidal
Jehani, Fathi
author_facet Khalaf, Dina
Toema, Bassem
Dabbour, Nidal
Jehani, Fathi
author_sort Khalaf, Dina
collection PubMed
description Primary illness with cytomegalovirus leads to latent infection with possible reactivations especially in the immunocompromised patients. Toxic epidermal necrolysis is an immune mediated cytotoxic reaction. A fifty years old female diabetic hypertensive patient with end stage renal disease was admitted with fever of unknown origin, constitutional symptoms, vague upper gastrointestinal symptoms and skin rash. Upper gastrointestinal endoscopic biopsy confirmed her diagnosis with cytomegalovirus esophagitis and duodenitis. Cytomegalovirus immunoglobulin M and immunoglobulin G levels were negative but polymerase chain reaction showed fulminant viremia. Biopsy of the skin rash was consistent with toxic epidermal necrolysis. Despite treatment with Ganciclovir, intravenous immunoglobulins, and granulocyte colony stimulating factor the patient’s condition rapidly deteriorated and she died due to multiorgan failure, disseminated intravascular coagulopathy and overwhelming sepsis. Probably there is a true association linking toxic epidermal necrolysis to fulminant reactivation of cytomegalovirus. The aim of this anecdote is reporting a newly recognized presentation of cytomegalovirus.
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spelling pubmed-31032632011-05-27 Toxic epidermal necrolysis associated with severe cytomegalovirus infection in a patient on regular hemodialysis Khalaf, Dina Toema, Bassem Dabbour, Nidal Jehani, Fathi Mediterr J Hematol Infect Dis Case Report Primary illness with cytomegalovirus leads to latent infection with possible reactivations especially in the immunocompromised patients. Toxic epidermal necrolysis is an immune mediated cytotoxic reaction. A fifty years old female diabetic hypertensive patient with end stage renal disease was admitted with fever of unknown origin, constitutional symptoms, vague upper gastrointestinal symptoms and skin rash. Upper gastrointestinal endoscopic biopsy confirmed her diagnosis with cytomegalovirus esophagitis and duodenitis. Cytomegalovirus immunoglobulin M and immunoglobulin G levels were negative but polymerase chain reaction showed fulminant viremia. Biopsy of the skin rash was consistent with toxic epidermal necrolysis. Despite treatment with Ganciclovir, intravenous immunoglobulins, and granulocyte colony stimulating factor the patient’s condition rapidly deteriorated and she died due to multiorgan failure, disseminated intravascular coagulopathy and overwhelming sepsis. Probably there is a true association linking toxic epidermal necrolysis to fulminant reactivation of cytomegalovirus. The aim of this anecdote is reporting a newly recognized presentation of cytomegalovirus. Università Cattolica del Sacro Cuore 2011-01-14 /pmc/articles/PMC3103263/ /pubmed/21625308 http://dx.doi.org/10.4084/MJHID.2011.004 Text en This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Khalaf, Dina
Toema, Bassem
Dabbour, Nidal
Jehani, Fathi
Toxic epidermal necrolysis associated with severe cytomegalovirus infection in a patient on regular hemodialysis
title Toxic epidermal necrolysis associated with severe cytomegalovirus infection in a patient on regular hemodialysis
title_full Toxic epidermal necrolysis associated with severe cytomegalovirus infection in a patient on regular hemodialysis
title_fullStr Toxic epidermal necrolysis associated with severe cytomegalovirus infection in a patient on regular hemodialysis
title_full_unstemmed Toxic epidermal necrolysis associated with severe cytomegalovirus infection in a patient on regular hemodialysis
title_short Toxic epidermal necrolysis associated with severe cytomegalovirus infection in a patient on regular hemodialysis
title_sort toxic epidermal necrolysis associated with severe cytomegalovirus infection in a patient on regular hemodialysis
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3103263/
https://www.ncbi.nlm.nih.gov/pubmed/21625308
http://dx.doi.org/10.4084/MJHID.2011.004
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