Human cytomegalovirus pneumonia in an immunocompetent patient: a very uncommon but treatable condition

BMJ Case Rep. 2019 Aug 26;12(8):e230229. doi: 10.1136/bcr-2019-230229.

Abstract

Human cytomegalovirus (CMV) is a double-stranded DNA virus that can cause widespread severe infection in immunocompromised individuals but is more typically a subclinical infection in immunocompetent individuals. Rarely, it can cause a serious infection in immunocompetent individuals. Here, we describe a 36-year-old otherwise healthy male who presented with fever, cough and malaise who was diagnosed with CMV pneumonia. He made a rapid recovery after initiation of ganciclovir and has been doing well on follow-up visits. We performed a comprehensive review of CMV pneumonia in immunocompetent individuals and have summarised the prior 16 reported cases of CMV pneumonia in immunocompetent patients. This article highlights the importance of considering CMV as a cause of pneumonia even in immunocompetent individuals, especially when the more common causes have been excluded. Early diagnosis allows prompt treatment and potentially complete recovery.

Keywords: pneumonia (infectious disease); pneumonia (respiratory medicine); respiratory medicine.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antiviral Agents / administration & dosage
  • Cytomegalovirus / isolation & purification*
  • Cytomegalovirus Infections* / diagnosis
  • Cytomegalovirus Infections* / drug therapy
  • Cytomegalovirus Infections* / immunology
  • Cytomegalovirus Infections* / physiopathology
  • Early Diagnosis
  • Early Medical Intervention / methods*
  • Ganciclovir / administration & dosage*
  • Humans
  • Immunocompetence
  • Male
  • Pneumonia* / diagnosis
  • Pneumonia* / drug therapy
  • Pneumonia* / physiopathology
  • Pneumonia* / virology
  • Treatment Outcome

Substances

  • Antiviral Agents
  • Ganciclovir