Associates' Presentations
Intro | Prev | Next | Last  

Cytomegalovirus Monoucleosis

MC Hall, LK Heath. Marshfield Clinic, Marshfield, WI

We present a case of cytomegalovirus infection in an immunocompetent 30 year old male who presented to our facility after a three-week illness which began with upper respiratory infections (URI) symptoms. We will also present statistics related to the incidence and prevalence rates for cytomegalovirus infections at a tertiary care center in rural an area. Although the URI symptoms resolved within a few days, fever, chills, headaches, malaise, and myalgias continued. The patient was treated for the URI symptoms with antibiotics. Due to continuing symptoms, he presented to an emergency room. At that time he was found to have splenomegaly and mild pancytopenia (WBC 3,300 with 43% lymphocytes, and 10% atypical lymphocytes; hemoglobin 12.4 gm/dL; platelet count 96,000). Abdominal ultrasound confirmed an enlarged spleen size of 16.5 cm by 6.3 cm with a normal echogenic pattern. He subsequently sought care at our institution. On examination, he had a temperature of 97.0, a pulse of 116, and blood pressure of 140/76. He had a tender palpable liver edge 2 cm below the right costal margin and a palpable spleen 3 cm below the left costal margin. No jaundice or scleral icteres were noted. Small anterior cervical nodes were palpable. He became febrile to 103.0 within 2 hours of admission. Laboratory studies confirmed the lymphocytosis. In addition, liver transaminases were elevated. Additional studies documented previous EBV infection, and a positive urine culture for CMV. Peripheral blood leukocytes were also positive for CMV antigen. In retrospect, the patient's social history was of interest in that he has pre-school age children at home who attended day-care. Children have been documented to disseminate CMV into a family (Yarrish et al. Postgrad Med. 85:251, 1989).

Intro | Prev | Next | Last

What's New

Contact Information

Sharon Haase, MD, FACP
Chapter Governor

Kelly Lang
Chapter Support Staff
Ph: 414-755-6280
E-mail: lang@svinicki.com