Service de maladies infectieuses et tropicales, centre hospitalier universitaire de Lille, 2, avenue Oscar-Lambret, 59000 Lille, France; Service de maladies infectieuses et tropicales, centre hospitalier de Tourcoing, 155, rue du Président-Coty, 59200 Tourcoing, France.
Service de maladies infectieuses et tropicales, hôpital militaire Bégin, 69, avenue de Paris, 94160 Saint-Mandé, France.
Med Mal Infect. 2016 Mar;46(2):87-92. doi: 10.1016/j.medmal.2015.12.013. Epub 2016 Feb 2.
Vascular thromboembolism (VTE) complicating cytomegalovirus (CMV) primary infection is increasingly reported in immunocompetent adults. No guideline is, however, currently available for the management of these infections and particularly for the antiviral therapy indication.
We performed a literature review of VTE complicating CMV primary infection in immunocompetent adults using PubMed.
Sixty-nine case patients of VTE complicating CMV primary infection were reported. The main sites of venous thrombosis were the splanchnic veins (30 patients) or those of the lower limbs (18 patients). One-third of patients presented with pulmonary embolism (25 patients). Forty-nine patients (76%) had at least one VTE risk factor, inherited or acquired thrombophilia for 37 patients (58%), and another risk factor for 27 patients (42%). Only 11 patients received an antiviral therapy. A positive outcome was observed in all patients.
We suggest that antiviral therapy should be considered for patients presenting with severe VTE, VTE with a negative outcome despite anticoagulation, severe organ involvement, or for patients managed in the intensive care unit.
免疫功能正常的成年人中，越来越多的人会出现巨细胞病毒（CMV）原发性感染合并血管血栓栓塞症（VTE）。然而，目前尚无针对这些感染的管理指南，特别是针对抗病毒治疗的适应证。
我们使用 PubMed 对免疫功能正常的成年人中 CMV 原发性感染合并 VTE 的文献进行了综述。
报告了 69 例 CMV 原发性感染合并 VTE 的病例患者。静脉血栓形成的主要部位为内脏静脉（30 例）或下肢静脉（18 例）。三分之一的患者出现肺栓塞（25 例）。49 例患者（76%）有至少一个 VTE 风险因素，37 例患者（58%）有遗传性或获得性血栓形成倾向，27 例患者（42%）有另一个风险因素。仅 11 例患者接受了抗病毒治疗。所有患者的结局均为阳性。
我们建议对于出现严重 VTE、抗凝治疗后 VTE 结局不佳、严重器官受累或在重症监护病房治疗的患者，应考虑进行抗病毒治疗。
