Cavitary lung lesion in a patient with systemic lupus erythematosus: an unusual manifestation of cytomegalovirus pneumonitis

Abstract

We report a 35-year-old female patient with systemic lupus erythematosus (SLE). She was admitted due to deterioration of lupus nephritis and received treatment with a high dose of steroid and cyclosporine. Approximately 1 month after admission, the patient was also treated for cytomegalovirus (CMV) infection because she was found to have CMV antigenemia. Although a cavitary lesion was shown by chest computed tomography (CT), its cause could not be clarified by blood examination, smears or cultures, or by bronchoscopy. We considered that this lesion may have been caused by CMV pneumonitis because it was resolved during the treatment for CMV infection. It is known that CMV causes opportunistic infections in patients with collagen vascular diseases (CVD) who are receiving immunosuppressive therapy. However, it is extremely rare for a cavitary lesion to be formed as a result of CMV pneumonitis. Here we describe the details of this interesting case.

Cavitary Lung Lesion in a Patient with Systemic Lupus Erythematosus: An Unusual Manifestation of Cytomegalovirus Pneumonia

“…A case showed single cavitary lesion without fever and diagnosed by transbronchial lung biopsy (TBLB) [6]. In Japan, a SLE patient with single cavitary lesion was diagnosed by CMV antigenemia only [7]. Another SLE patient combined usual manifestation image was diagnosed by TBLB and CMV antigenemia and treated with additional γglobulin [8].…”