Severe Cytomegalovirus Reactivation in Patient with Low-Grade Non-Hodgkin’s Lymphoma after Standard Chemotherapy

Clinically significant cytomegalovirus (CMV) reactivation is not uncommon in patients with severe immunodeficiency secondary to underlying medical disorders or following aggressive immunosuppressive therapy. However, it is less frequently found in patients with low-grade haematological malignancies...

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Bibliographic Details
Published in:Case reports in hematology 2017-01, Vol.2017 (2017), p.1-3
Main Authors: Borg, Anton, Randall, Katie, Boyle, Ciaran, Modvig, Lena
Format: Article
Language:English
Subjects:
Abdomen
Care and treatment
Case Report
Case reports
Case studies
Chemotherapy
Critical care
Cytomegalovirus
Cytomegalovirus infections
Development and progression
Drug dosages
Hematology
Hospitals
Infections
Infectious diseases
Inflammatory bowel disease
Leukemia
Lymphoma
Medical imaging
Medicine
Non-Hodgkin's lymphomas
Patients
Pneumonia
Transplants & implants
Viral infections
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Description
Summary:Clinically significant cytomegalovirus (CMV) reactivation is not uncommon in patients with severe immunodeficiency secondary to underlying medical disorders or following aggressive immunosuppressive therapy. However, it is less frequently found in patients with low-grade haematological malignancies after nonintensive chemotherapy. We treated a patient at our centre for stage IVB follicular lymphoma with standard chemotherapy who successively developed CMV colitis associated with a CMV viral load of >3 million copies/ml. Four lines of antiviral treatment were necessary to obtain biochemical remission with undetectable CMV levels, with an initially insufficient response to valganciclovir despite therapeutic pre- and posttreatment levels. Subsequently, our patient also developed an infection with Pneumocystis jirovecii pneumonia (PJP) as further evidence of severe immune compromise. This case report demonstrates the importance of including investigations for less common sources of infection when confronted with a patient with a low-grade haematological malignancy and a pyrexia of unknown origin.
ISSN:2090-6560
2090-6579
DOI:10.1155/2017/5762525