Prasad Narayan, Jain Manoj, Gupta Amit, Sharma Raj K, Agarwal Vinita
Department of Nephrology and Pathology , Sanjay Gandhi Postgraduate Institute of Medical Sciences , Lucknow , India.
NDT Plus. 2010 Aug;3(4):379-82. doi: 10.1093/ndtplus/sfq082. Epub 2010 May 7.
Cytomegalovirus (CMV) infection involving the skin is rare. We present a case of a renal transplant recipient who developed fever and axillary, scrotal and penile skin ulcers after renal transplantation. The skin ulcers did not heal with antibiotics. The skin biopsy revealed CMV inclusion bodies, CMV antigen on immunohistochemistry and high CMV DNA copies. The patient was diagnosed with CMV cutaneous ulcers. The skin ulcers healed after treatment with intravenous ganciclovir and oral valganciclovir. The diagnosis of CMV disease should be considered in the febrile immunosuppressed patient with skin ulcers. The biopsy of the cutaneous lesions may provide the diagnostic clue in such patients.
巨细胞病毒(CMV)感染累及皮肤较为罕见。我们报告一例肾移植受者,该患者在肾移植后出现发热以及腋窝、阴囊和阴茎皮肤溃疡。使用抗生素后皮肤溃疡未愈合。皮肤活检显示有CMV包涵体、免疫组织化学检测发现CMV抗原以及CMV DNA高拷贝数。该患者被诊断为CMV皮肤溃疡。经静脉注射更昔洛韦和口服缬更昔洛韦治疗后,皮肤溃疡愈合。对于发热的免疫抑制且有皮肤溃疡的患者,应考虑CMV疾病的诊断。皮肤病变活检可为这类患者提供诊断线索。