Maita Hiroki, Tonosaki Kanata, Ozawa Amo, Kobayashi Tadashi, Akimoto Takashi, Mizuno Takashi, Ogino Masaya, Teshiromori Takashi, Narita Shigeki, Miura Yuka, Hanada Hiroyuki
Development of Community Healthcare, Hirosaki University Graduate School of Medicine, Aomori, Japan.
Department of General Medicine, Towada City Hospital, Aomori, Japan.
SAGE Open Med Case Rep. 2024 Jul 26;12:2050313X241266766. doi: 10.1177/2050313X241266766. eCollection 2024.
A 53-year-old otherwise healthy man was referred to our hospital with a fever of unknown origin, headache, and arthralgia. Four days earlier, he had a fever with chills. Treatment with antibiotics and acetaminophen proved ineffective, with the patient subsequently developing headache and joint pain. Blood analysis revealed elevated inflammatory markers, liver impairment, and severe thrombocytopenia (platelet count, 19,000/μL). Subsequent tests revealed elevated levels of anti-cytomegalovirus IgM and IgG. Based on these findings, the patient was diagnosed with severe thrombocytopenia associated with cytomegalovirus infection. Platelet counts increased spontaneously without antiviral therapy. Forty-five days after the initial visit, the symptoms improved, and blood tests revealed resolution of the inflammatory findings, with the platelet count recovering to 155,000/μL. Although the disease may resolve spontaneously, cytomegalovirus infection should be considered as a differential diagnosis in case of severe thrombocytopenia in immunocompetent adults.
一名53岁的身体健康男子因不明原因发热、头痛和关节痛被转诊至我院。四天前，他开始发热并伴有寒战。使用抗生素和对乙酰氨基酚治疗无效，随后患者出现头痛和关节疼痛。血液分析显示炎症指标升高、肝功能损害和严重血小板减少（血小板计数为19,000/μL）。随后的检查显示抗巨细胞病毒IgM和IgG水平升高。基于这些发现，患者被诊断为与巨细胞病毒感染相关的严重血小板减少症。未经抗病毒治疗，血小板计数自发上升。初次就诊45天后，症状改善，血液检查显示炎症指标恢复正常，血小板计数恢复至155,000/μL。尽管该疾病可能会自发缓解，但对于免疫功能正常的成年人出现严重血小板减少症时，应考虑巨细胞病毒感染作为鉴别诊断。
