Severe cytomegalovirus reactivation in patient with low-grade non-Hodgkin’s lymphoma after standard chemotherapy
Modvig, Lena Boyle, Ciaran Randall, Katie Borg, Anton
Modvig, Lena
Boyle, Ciaran
Randall, Katie
Borg, Anton
Abstract
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.
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Date
2017-10-22
Type
Article
Subject
Haematology, Microbiology. Immunology
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Citation
Modvig L, Boyle C, Randall K, Borg A. Severe Cytomegalovirus Reactivation in Patient with Low-Grade Non-Hodgkin's Lymphoma after Standard Chemotherapy. Case Rep Hematol. 2017;2017:5762525. doi: 10.1155/2017/5762525. Epub 2017 Oct 22.
Journal / Source Title
Case Reports in Hematology
DOI
10.1155/2017/5762525
PMID
29201472
Publisher
Wiley
Publisher’s URL
https://pmc.ncbi.nlm.nih.gov/articles/PMC5671693/