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Spencer D. Darlin, Thomas R. Fennell, Brett A. Holmes, Paul Chittick, Enrique I. Soltero, Bobby L. Boyanton, Jr.
(Medical Student, Oakland University William Beaumont School of Medicine, Rochester, USA)
Med Sci Case Rep 2018; 5:56-59
Cytomegalovirus (CMV) rarely causes symptomatic infection in immunocompetent hosts. In such cases, clinical signs and symptoms manifest differently than in the immunocompromised host.
CASE REPORT: We present the clinical course of an immunocompetent 18-year-old female with no significant past medical history admitted for CMV-associated hepatitis. Prior to admission, she experienced epigastric pain, malaise, and intermittent fevers of 4 days duration. Initial laboratory testing showed elevated liver enzymes and eosinophilia. Over the next 3 weeks, CMV seroconversion was observed.
CONCLUSIONS: Immunocompetent individuals rarely experience symptoms associated with primary CMV infection. As with our patient, immunocompetent individuals may experience an exaggerated disease course with eosinophilia. Recognition of such atypical cases is paramount to appropriately diagnose and manage these patients. CMV infection in the immunocompetent host should be included in the differential diagnosis when hepatitis and/or eosinophilia is present.