Cutaneous Ulcer as Leading Symptom of Systemic Cytomegalovirus Infection
Cytomegalovirus (CMV) infection rarely manifests with skin ulcerations. We describe a case report of a 64-year-old woman with chronic immunosuppression for treatment of mixed connective tissue disease, presenting with new onset leg ulcerations after a recent change in immunosuppressive regimen. She...
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2015-01-01
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Series: | Case Reports in Infectious Diseases |
Online Access: | http://dx.doi.org/10.1155/2015/723962 |
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doaj-9c4416175f49425bb390b3227901b0b42020-11-25T00:11:58ZengHindawi LimitedCase Reports in Infectious Diseases2090-66252090-66332015-01-01201510.1155/2015/723962723962Cutaneous Ulcer as Leading Symptom of Systemic Cytomegalovirus InfectionRichard F. Guo0Frew H. Gebreab1Emily Hsiang-Ho Tang2Zhe Piao3Steve S. Lee4Mario L. Perez5Department of Internal Medicine, Southern California Permanente Medical Group, Fontana, CA 92335, USADepartment of Internal Medicine, Southern California Permanente Medical Group, Fontana, CA 92335, USADepartment of Dermatology, Southern California Permanente Medical Group, Fontana, CA 92335, USADepartment of Pathology, Southern California Permanente Medical Group, Fontana, CA 92335, USADepartment of Rheumatology, Southern California Permanente Medical Group, Fontana, CA 92335, USADepartment of Infectious Diseases, Southern California Permanente Medical Group, Fontana, CA 92335, USACytomegalovirus (CMV) infection rarely manifests with skin ulcerations. We describe a case report of a 64-year-old woman with chronic immunosuppression for treatment of mixed connective tissue disease, presenting with new onset leg ulcerations after a recent change in immunosuppressive regimen. She subsequently developed fulminant hepatitis, encephalopathy, and pancytopenia and was found to have severe systemic CMV viremia. Skin ulcer biopsy was positive by immunohistochemical staining for CMV infected endothelial cells. Both systemic disease and skin ulcer rapidly improved after stopping immunosuppression and administering intravenous ganciclovir. New onset skin ulcers in an immunosuppressed individual, especially with recent changes in immunosuppressive regimen, should raise the suspicion of reactivation of CMV.http://dx.doi.org/10.1155/2015/723962 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Richard F. Guo Frew H. Gebreab Emily Hsiang-Ho Tang Zhe Piao Steve S. Lee Mario L. Perez |
spellingShingle |
Richard F. Guo Frew H. Gebreab Emily Hsiang-Ho Tang Zhe Piao Steve S. Lee Mario L. Perez Cutaneous Ulcer as Leading Symptom of Systemic Cytomegalovirus Infection Case Reports in Infectious Diseases |
author_facet |
Richard F. Guo Frew H. Gebreab Emily Hsiang-Ho Tang Zhe Piao Steve S. Lee Mario L. Perez |
author_sort |
Richard F. Guo |
title |
Cutaneous Ulcer as Leading Symptom of Systemic Cytomegalovirus Infection |
title_short |
Cutaneous Ulcer as Leading Symptom of Systemic Cytomegalovirus Infection |
title_full |
Cutaneous Ulcer as Leading Symptom of Systemic Cytomegalovirus Infection |
title_fullStr |
Cutaneous Ulcer as Leading Symptom of Systemic Cytomegalovirus Infection |
title_full_unstemmed |
Cutaneous Ulcer as Leading Symptom of Systemic Cytomegalovirus Infection |
title_sort |
cutaneous ulcer as leading symptom of systemic cytomegalovirus infection |
publisher |
Hindawi Limited |
series |
Case Reports in Infectious Diseases |
issn |
2090-6625 2090-6633 |
publishDate |
2015-01-01 |
description |
Cytomegalovirus (CMV) infection rarely manifests with skin ulcerations. We describe a case report of a 64-year-old woman with chronic immunosuppression for treatment of mixed connective tissue disease, presenting with new onset leg ulcerations after a recent change in immunosuppressive regimen. She subsequently developed fulminant hepatitis, encephalopathy, and pancytopenia and was found to have severe systemic CMV viremia. Skin ulcer biopsy was positive by immunohistochemical staining for CMV infected endothelial cells. Both systemic disease and skin ulcer rapidly improved after stopping immunosuppression and administering intravenous ganciclovir. New onset skin ulcers in an immunosuppressed individual, especially with recent changes in immunosuppressive regimen, should raise the suspicion of reactivation of CMV. |
url |
http://dx.doi.org/10.1155/2015/723962 |
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