Disseminated CMV infection and HLH in a patient with well-controlled HIV and ulcerative colitis

Abstract

We present a case of haemophagocytic lymphohistiocytosis (HLH) in the context of disseminated cytomegalovirus (CMV) viraemia in a 50-year-old man with well-controlled HIV infection and ulcerative colitis (UC), for which he was receiving azathioprine. Peak CMV viral load was 371 000 copies/ml with evidence of end-organ CMV in the lungs and colon. A bone marrow biopsy showed evidence of haemophagocytosis of platelets, neutrophils and erythrocytes. The azathioprine was stopped, and he received intravenous ganciclovir and corticosteroids with suppression of the CMV viral load and resolution of the HLH.

Multisystem cytomegalovirus end-organ disease in a patient with advanced HIV

“…1 The multisystem complications of CMV EOD are well described; however, only a few case reports can be found in the literature which describe patients with simultaneous multisystem CMV EOD. 2,3 In this case report, we describe a patient with advanced HIV and multiple end-organ manifestations of CMV disease.…”