Mares Bermúdez J, Plaja Román P, Calico Bosch I, Javier Manchón G, Ortega Aramburu J J
Hospital Infantil Valle de Hebrón, Universidad Autónoma de Barcelona.
An Esp Pediatr. 1988 Mar;28(3):211-6.
Cytomegalovirus (CMV) infection is relatively frequent and severe in immunosuppressed patients giving rise to diagnostic and therapeutic problems. We describe a series of 7 patients, six with acute lymphoblastic leukemia and one with aplastic anemia. All patients had CMV infection at the moment of maximum immunodepression. Two patients had undergone recent bone-marrow transplant. Six had been transfused in the two months prior to the onset of infection. Diagnosis was established through isolation of CMV from blood or serological methods. Symptoms ranged from prolonged fever to multi-organic involvement. Two cases had pulmonary involvement as well as fever, hepatitis and petechial rash. Two other cases presented with fever and hepatosplenomegaly and in the remaining, 3, fever was the only sign. Clinical course was favourable in all cases including the two with pneumonitis; of these two the first received acyclovir and anti-CMV Ig and the other received no specific therapy. One of the remaining cases was also given acyclovir and specific anti CMV Ig was administered to the 3 patients with isolated fever. In conclusion, CMV infection should be suspected in immunosuppressed patients with prolonged fever.
巨细胞病毒（CMV）感染在免疫抑制患者中相对常见且严重，会引发诊断和治疗方面的问题。我们描述了一组7例患者，其中6例患有急性淋巴细胞白血病，1例患有再生障碍性贫血。所有患者在免疫抑制最严重时均感染了CMV。2例患者近期接受了骨髓移植。6例在感染发作前两个月内接受过输血。通过从血液中分离出CMV或血清学方法确诊。症状从持续发热到多器官受累不等。2例有肺部受累以及发热、肝炎和瘀点性皮疹。另外2例表现为发热和肝脾肿大，其余3例仅有发热这一症状。所有病例，包括2例肺炎患者，临床病程均良好；这2例肺炎患者中，第一例接受了阿昔洛韦和抗CMV免疫球蛋白治疗，另一例未接受特殊治疗。其余病例中有1例也接受了阿昔洛韦治疗，3例仅有发热症状的患者接受了特异性抗CMV免疫球蛋白治疗。总之，对于持续发热的免疫抑制患者应怀疑CMV感染。
