病例报告：一名免疫功能正常的成年人发生严重巨细胞病毒原发性感染并伴有弥散性血管内凝血，接受缬更昔洛韦治疗。
Case report: severe cytomegalovirus primary infection in an immunocompetent adult with disseminated intravascular coagulation treated with valganciclovir.
作者信息
Müller Niklas F, Schampera Matthias, Jahn Gerhard, Malek Nisar P, Berg Christoph P, Hamprecht Klaus
机构信息
Department of Internal Medicine I, University Hospital of Tuebingen, D-72076 Tuebingen, Germany.
Institute of Medical Virology and Epidemiology of Viral Diseases, University Hospital of Tuebingen, D-72076 Tuebingen, Germany.
出版信息
BMC Infect Dis. 2016 Jan 19;16:19. doi: 10.1186/s12879-016-1343-3.
BACKGROUND
Disseminated intravascular coagulation (DIC) is a very rare complication of disseminated cytomegalovirus (CMV) infection. So far it is mainly described for immunocompromised patients.
CASE PRESENTATION
A 49-year-old immunocompetent Caucasian male presented with sudden onset of fever and DIC due to primary CMV infection, which was treated with Valganciclovir. CMV-specific IgG-avidity and epithelial cell-specific neutralisation-capacity developed five weeks after onset of symptoms. We describe the first case of an immunocompetent patient suffering from DIC due to a CMV primary infection successfully treated with Valganciclovir.
CONCLUSIONS
Primary CMV infection can occur accompanied with life threatening complications even in immunocompetent patients. Immediate treatment with Valganciclovir should be considered as an early treatment of choice in severe cases since specific neutralisation capacity might need several weeks to develop.
背景
弥散性血管内凝血（DIC）是弥散性巨细胞病毒（CMV）感染非常罕见的并发症。到目前为止，主要在免疫功能低下的患者中有所描述。
病例报告
一名49岁免疫功能正常的白种男性因原发性CMV感染出现突发发热和DIC，接受了缬更昔洛韦治疗。症状出现五周后，CMV特异性IgG亲和力和上皮细胞特异性中和能力出现。我们描述了首例因原发性CMV感染导致DIC的免疫功能正常患者，经缬更昔洛韦成功治疗。
结论
即使在免疫功能正常的患者中，原发性CMV感染也可能伴有危及生命的并发症。对于严重病例，应考虑立即使用缬更昔洛韦进行早期治疗，因为特异性中和能力可能需要数周才能形成。
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