Cytomegalovirus: A growing problem
AFTER TRAVELING to Puerto Rico, JD, a 57-year-old commercial salesman, presented to his primary care provider with dysuria, fatigue, malaise, and a low-grade fever. He had a history of hypertension, dyslipidemia, and type 2 diabetes that were all well controlled with medications. His provider diagnosed a urinary tract infection (UTI) and prescribed an antibiotic.
Although his urinary signs and symptoms improved, the fatigue continued and JD developed a cough a few weeks later. He was diagnosed with serum sickness from his UTI treatment and prescribed steroids. His cough improved, but, despite multiple rounds of antibiotics, the underlying fatigue and low-grade fever did not resolve. He later required hospitalization and parenteral antibiotics after being diagnosed with bacterial pneumonia.
A year after his initial presentation, JD was admitted to the hospital with sepsis and a 103° F (39.4° C) fever. The infectious disease team was consulted, and a thorough workup was completed. JD tested negative for syphilis, influenza, Epstein-Barr virus, herpes simplex virus, and Lyme disease.
JD's health history revealed that, following vague symptoms, his wife had been diagnosed with cytomegalovirus (CMV) 11 years earlier. His lab work was positive for CMV immunoglobulin M (IgM) and negative for immunoglobulin G (IgG), indicating a recent infection, and his CMV viral load was significant (see CMV lab analysis and interpretation). JD had an active CMV infection.
Masco-Dixon, Natalie (2019). "Cytomegalovirus: A growing problem." Nursing2019 49.9, 66-69.
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