Zarowin Diana, Coe Jared, Bressman Maxwell, Riska Paul, Yune Philip, Halaseh Ghaleb, Akiyama Matthew J
Albert Einstein College of Medicine, Bronx, New York.
Department of Medicine, Division of Infectious Diseases, Montefiore Medical Center, Bronx, New York.
Ann Intern Med Clin Cases. 2024 Jun;3(6). doi: 10.7326/aimcc.2023.1153. Epub 2024 Jun 4.
We present a case of multidrug-resistant Cytomegalovirus (CMV) and the use of maribavir, a novel oral treatment of resistant CMV, in a nontransplant immunocompromised host. Our patient initially was diagnosed with CMV pharyngitis on biopsy. Although his initial CMV pharyngitis resolved, the CMV isolated from blood became resistant to ganciclovir and cidofovir and eventually required treatment with foscarnet. Our patient was given a trial of maribavir. After 6 weeks, the patient's viremia resolved and remained undetectable for 6 months after treatment initiation with maribavir. This case demonstrates the feasibility of using maribavir for resistant CMV in a nontransplant, immunocompromised patient.
我们报告了一例耐多药巨细胞病毒(CMV)感染病例,以及在一名非移植免疫功能低下宿主中使用新型口服抗耐药CMV药物马立巴韦的情况。我们的患者最初经活检诊断为CMV咽炎。尽管其最初的CMV咽炎得到缓解,但从血液中分离出的CMV对更昔洛韦和西多福韦产生了耐药性,最终需要膦甲酸钠治疗。我们的患者接受了马立巴韦试验性治疗。6周后,患者的病毒血症得到缓解,在开始使用马立巴韦治疗后的6个月内一直检测不到病毒。该病例证明了在非移植免疫功能低下患者中使用马立巴韦治疗耐药CMV的可行性。