Poh Kai Chin, Zheng Shuwei
Department of General Medicine, Sengkang General Hospital, Singapore, 110 Sengkang E Way, 544886, Singapore.
Respir Med Case Rep. 2019 Oct 16;28:100945. doi: 10.1016/j.rmcr.2019.100945. eCollection 2019.
Cytomegalovirus (CMV) pneumonia is a rare opportunistic infection in the setting of HIV (Human Immunodeficiency Virus)-infection. Establishing accurate diagnosis of CMV pneumonia in HIV-infection can be challenging. Co-infections by multiple opportunistic pathogens are common and a high degree of clinical vigilance to evaluate for multiple infections, including CMV pneumonia, should be maintained. As there can be a degree of overlap in clinical and radiological features amongst different opportunistic infections affecting the lungs, definitive microbiological and cytohistologic evidences are needed. Reliance on microbiological evidence of CMV in respiratory specimens alone for the diagnosis of CMV pneumonia will lead to an over-diagnosis of the condition and unnecessary treatment. In our case report, we describe a 53-year-old man with recently diagnosed HIV-infection who presented with non-resolving pneumonia. A diagnosis of CMV pneumonia was reached through consistent clinical, radiological, microbiological and cytologic investigations. The patient made a full clinical recovery after being started on -CMV treatment.
巨细胞病毒（CMV）肺炎是人类免疫缺陷病毒（HIV）感染情况下一种罕见的机会性感染。在HIV感染中准确诊断CMV肺炎可能具有挑战性。多种机会性病原体合并感染很常见，应保持高度的临床警惕性以评估包括CMV肺炎在内的多种感染。由于影响肺部的不同机会性感染在临床和影像学特征上可能存在一定程度的重叠，因此需要明确的微生物学和细胞组织学证据。仅依靠呼吸道标本中CMV的微生物学证据来诊断CMV肺炎会导致对该病的过度诊断和不必要的治疗。在我们的病例报告中，我们描述了一名53岁近期诊断为HIV感染的男性，他患有持续性肺炎。通过一致的临床、影像学、微生物学和细胞学检查确诊为CMV肺炎。患者在开始接受CMV治疗后实现了完全临床康复。
