Salvage Treatment with Ganciclovir in a Splenectomized, Polytransfused Patient Affected by Systemic Inflammatory Response Syndrome

A 23-year-old man was admitted to hospital with a 12-day history of daily fever. A clinical history revealed that 10 months previously, the patient had been splenectomized and polytransfused for a severe blunt trauma. On admission, laboratory data revealed significant leukocytosis (33,230/ul). The p...

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Bibliographic Details
Published in:International journal of immunopathology and pharmacology 2014-04, Vol.27 (2), p.267-272
Main Authors: Torres, D., Parrinello, G., Bellanca, M., Marrone, R., Cuttitta, F., Virzi, G., Pizzo, G., Petrantoni, R., Licata, G.
Format: Article
Language:English
Subjects:
Administration, Intravenous
Antiviral Agents - administration & dosage
Antiviral Agents - therapeutic use
Blood Transfusion
Cytomegalovirus Infections - diagnosis
Cytomegalovirus Infections - drug therapy
Cytomegalovirus Infections - virology
Evidence-Based Medicine
Ganciclovir - administration & dosage
Ganciclovir - therapeutic use
Humans
Male
PubMed
Salvage Therapy
Splenectomy
Systemic Inflammatory Response Syndrome - diagnosis
Systemic Inflammatory Response Syndrome - drug therapy
Systemic Inflammatory Response Syndrome - virology
Time Factors
Treatment Outcome
Wounds, Nonpenetrating - therapy
Young Adult
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Summary:A 23-year-old man was admitted to hospital with a 12-day history of daily fever. A clinical history revealed that 10 months previously, the patient had been splenectomized and polytransfused for a severe blunt trauma. On admission, laboratory data revealed significant leukocytosis (33,230/ul). The patient's general clinical conditions rapidly worsened into a severe systemic inflammatory response syndrome in four days. After 10 days of broad-spectrum antibiotic treatment, the temperature curve was unmodified and severe leukocytosis persisted (44,300 ul) with absolute lymphocytosis. Laboratory tests ruled out hematological diseases, pneumonia, abscesses and endocarditis. In the light of IgM positivity for CMV (unconfirmed by PCR) and with the support of a PubMed search, we commenced a salvage treatment with intravenous ganciclovir, suspecting a viral infection or reactivation. After two days of therapy, an immediate defervescence was observed with a remarkable clinical improvement. After 10 days, the clinical syndrome had been completely resolved and the patient was discharged in good, general clinical health.
ISSN:0394-6320
2058-7384
DOI:10.1177/039463201402700214