Acute Cytomegalovirus (CMV) Hepatitis in an Immunocompetent Adult

Patient: Male, 35-year-old Final Diagnosis: CMV infection Symptoms: Fever Medication: — Clinical Procedure: — Specialty: Gastroenterology and Hepatology • Infectious Diseases OBJECTIVE: Challenging differential diagnosis BACKGROUND: Cytomegalovirus (CMV) is a member of Herpesviridae family with its name derived from the fact that it causes enlargement of the infected cell resulting in the characteristic inclusion bodies seen on microscopy. CMV virus has an incubation period of about 4 to 6 weeks. Symptoms of CMV infection vary and depend on factors including the age and immune status of the patient. It usually presents as asymptomatic infection in immuno-competent individuals whereas severe disease is usually seen in immunocompromised patients. Here we present a case of an immunocompetent patient who presented with acute CMV hepatitis. CASE REPORT: A 35-year-old male with no significant prior medical history who presented to the Emergency Department with a 2-week history of low-grade fever. Acute CMV infection was diagnosed by positive CMV antibody and polymerase chain reaction (PCR) testing. The patient was treated with valganciclovir that resulted in rapid improvement in clinical status as well as normalization of the liver enzymes. CONCLUSIONS: This article presents a rare case of immunocompetent young male with acute CMV hepatitis who responded favorably to antiviral therapy.