바로가기메뉴

본문 바로가기 주메뉴 바로가기

A Case of Diffuse Alveolar Hemorrhage Associated with Cytomegalovirus Pneumonia

Tuberculosis & Respiratory Diseases / Tuberculosis & Respiratory Diseases,
2008, v.64 no.4, pp.309-313



  • Downloaded
  • Viewed

Abstract

Cytomegalovirus (CMV) pneumonia is a serious opportunistic infection in an immunocompromised host such as an AIDS patient or transplant recipient undergoing immunosuppressive therapy. Diffuse alveolar hemorrhage (DAH) is a relatively uncommon condition and it occurs most often in patients with systemic autoimmune disease. However, various types of infectious pneumonia with Mycoplsma hominis, Stenotrophomonas maltophilia and Pneumocystis jirovecii have been reported to be associated with the development of DAH. The association of CMV infection with the development of DAH has rarely been reported. We experienced a case of DAH associated CMV pneumonia and the patient was successfully treated with the use of antiviral agents and steroids.

keywords
Cytomegalovirus infections, Diffuse alveolar hemorrhage

Reference

1.

1. Riddell SR. Pathogenesis of cytomegalovirus pneumonia in immunocompromised hosts. Semin Respir Infect1995;10:199-208.

2.

2. Ham HS, No GH, Kang EH, Kang SJ, An CH, Suh GY,et al. The clinical characteristics of diffuse alveolar hemorrhage: a retrospective study of 21 cases. Tuberc Respir Dis 2000;49:614-23.

3.

3. De Lassence A, Fleury-Feith J, Escudier E, Beaune J,Bernaudin JF, Cordonnier C. Alveolar hemorrhage.Diagnostic criteria and results in 194 immunocompromised hosts. Am J Respir Crit Care Med 1995;151:157-63.

4.

4. Vincent B, Flahault A, Antoine M, Wislez M, Parrot A,Mayaud C, et al. AIDS-related alveolar hemorrhage: a prospective study of 273 BAL procedures. Chest 2001;120:1078-84.

5.

5. Kane JR, Shenep JL, Krance RA, Hurwitz CA. Diffuse alveolar hemorrhage associated with Mycoplasma hominis respiratory tract infection in a bone marrow transplant recipient. Chest 1994;105:1891-2.

6.

6. Ortin X, Jaen-Martinez J, Rodriguez-Luaces M, Alvaro T,Font L. Fatal pulmonary hemorrhage in a patient with myelodysplastic syndrome and fulminant pneumonia caused by Stenotrophomonas maltophilia. Infection2007;35:201-2.

7.

7. Heo WY, Jung WJ, Lee YJ, Park SD, Lee SW, Park MJ,et al. A case of pneumocystis carinii pneumonia with diffuse pulmonary hemorrhage. Tuberc Respir Dis2004;57:372-6.

8.

8. Tsushima K, Koyama S, Takematsu H, Okada K, Hata S, Ichiyoshi T, et al. Massive pulmonary hemorrhage due to cytomegalovirus infection in a Japanese patient with alpha-1-antitrypsin-deficient emphysema. Respiration1999;66:373-6.

9.

9. Herry I, Cadranel J, Antoine M, Meharzi J, Michelson S, Parrot A, et al. Cytomegalovirus-induced alveolar hemorrhage in patients with AIDS: a new clinical entity?Clin Infect Dis 1996;22:616-20.

10.

10. Shin HJ, Kim HK, Kim HS. The usefulness of PCR and early antigen immunostaining as a rapid identification method of cytomegalovirus infection. Kor J Clin Pathol 1998;18:452-7.

11.

11. Meyers JD, Flournoy N, Thomas ED. Risk factors for cytomegalovirus infection after human marrow transplantation.J Infect Dis 1986;153:478-88.

12.

12. Kahn FW, Jones JM, England DM. Diagnosis of pulmonary hemorrhage in the immunocompromised host.Am Rev Respir Dis 1987;136:155-60.

13.

13. Magro CM, Crowson AN, Ferri C. Cytomegalovirus-associated cutaneous vasculopathy and scleroderma sans inclusion body change. Hum Pathol 2007;38:42-9.

14.

14. Magro C, Ali N, Williams JD, Allen JN, Ross P Jr.Cytomegalovirus-associated pulmonary septal capillary injury sine inclusion body change: a distinctive cause of occult or macroscopic pulmonary hemorrhage in the immunocompetent host. Appl Immunohistochem Mol Morphol 2005;13:268-72.

15.

15. Chang WI, Oh JH, Han HW, Kim SH, Kim YS, Son SH,et al. Fatal cytomegalovirus pneumonia in a immunocompetent patient. Korean J Infect Dis 2000;32:78-81.

Tuberculosis & Respiratory Diseases