CMV Infection Presenting as a Cavitary Lung Lesion in a Patient with Systemic Lupus Erythematosus Receiving Immunosuppressive Therapy

Naoto Azuma; Naoaki Hashimoto; Akihiro Yasumitsu; Kazuya Fukuoka; Kazunori Yokoyama; Hisashi Sawada; Aki Nishioka; Masahiro Sekiguchi; Masayasu Kitano; Takanori Kuroiwa; Kiyoshi Matsui; Hajime Sano

doi:10.2169/internalmedicine.48.2495

CASE REPORTS

CMV Infection Presenting as a Cavitary Lung Lesion in a Patient with Systemic Lupus Erythematosus Receiving Immunosuppressive Therapy

Naoto Azuma, Naoaki Hashimoto, Akihiro Yasumitsu, Kazuya Fukuoka, Kazunori Yokoyama, Hisashi Sawada, Aki Nishioka, Masahiro Sekiguchi, Masayasu Kitano, Takanori Kuroiwa, Kiyoshi Matsui, Hajime Sano

Author information

Naoto Azuma
Division of Rheumatology, Department of Internal Medicine, Hyogo College of Medicine
Naoaki Hashimoto
Division of Rheumatology, Department of Internal Medicine, Hyogo College of Medicine
Akihiro Yasumitsu
Division of Respiratory Medicine, Department of Internal Medicine, Hyogo College of Medicine
Kazuya Fukuoka
Division of Respiratory Medicine, Department of Internal Medicine, Hyogo College of Medicine
Kazunori Yokoyama
Division of Rheumatology, Department of Internal Medicine, Hyogo College of Medicine
Hisashi Sawada
Division of Rheumatology, Department of Internal Medicine, Hyogo College of Medicine
Aki Nishioka
Division of Rheumatology, Department of Internal Medicine, Hyogo College of Medicine
Masahiro Sekiguchi
Division of Rheumatology, Department of Internal Medicine, Hyogo College of Medicine
Masayasu Kitano
Division of Rheumatology, Department of Internal Medicine, Hyogo College of Medicine
Takanori Kuroiwa
Division of Rheumatology, Department of Internal Medicine, Hyogo College of Medicine
Department of Internal Medicine, Ueki Hospital
Kiyoshi Matsui
Division of Rheumatology, Department of Internal Medicine, Hyogo College of Medicine
Hajime Sano
Division of Rheumatology, Department of Internal Medicine, Hyogo College of Medicine

Keywords: cavitary lung lesion, cytomegalovirus, immunosuppressant, opportunistic infection, systemic lupus erythematosus

JOURNAL OPEN ACCESS

2009 Volume 48 Issue 24 Pages 2145-2149

DOI https://doi.org/10.2169/internalmedicine.48.2495

Details

Abstract

We report a case of cytomegalovirus (CMV) pneumonitis that presented as a cavitary lung lesion in a patient with systemic lupus erythematosus receiving immunosuppressive treatment. The lesion was confirmed by positive polymerase chain reaction (PCR) for CMV in bronchoalveolar lavage fluid (BALF) and CMV antigenemia. PCR for CMV in BALF was demonstrated to be useful for the diagnosis of CMV pneumonitis on the basis of high sensitivity and specificity. After initiating ganciclovir, the lesion gradually regressed. A cavitary lung lesion associated with CMV is extremely rare. This presentation suggests that the differential diagnosis of cavitary lung lesion in immunocompromised individuals should include CMV.

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