Journal of Cardio-Thoracic Medicine

Journal of Cardio-Thoracic Medicine

Co- infectious Cytomegalovirus and Pneumocystis Jiroveci Pneumonia in a Polyarteritis Nodosa Patient: A Case Report

Document Type : Case Report

Authors
Fatemeh Sharafi 1
Mahnaz Mozdourian 2
Fariba Rezaeetalab 2
1 Residency of internal Medicine, Lung Diseases Research Center, Mashhad University of Medical Sciences
2 Pulmonologist, Lung Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
10.22038/jctm.2020.50210.1283
Abstract
Our report discusses a patient diagnosed with PAN since 3 years ago. He presented with fever, chills and nonproductive cough. He was a long time receiver of immunosuppressant drugs for his underlying condition. Upon examination he was febrile, had cushingoid appearance and cackles in both lungs. Lung CT scan showed opacities in right upper lobe lung and multiple bilateral nodules and ground glass opacity along with mild thickening of pleura. A bronchoscopy was ordered to asses PCP, and without hesitation empirical therapy was started. However, his clinical condition did not improve as expected. At this time, suspecting another infection at play, a PCR and BAL specimen was ordered for CMV. After receiving the result of BAL analysis, our suspicion was confirmed for both PCP and CMV pneumonia. CMV is an important opportunistic infection in immunocompromised individuals. This case highlights this importance in immunocompromising conditions. In this setting, presence of respiratory signs and symptoms point out to PCP as the first differential diagnosis; but at the same time it’s crucial for clinicians to consider the possibility of CMV as a co-infective agent.
Keywords
Co-infectious Cytomegalovirus
Pneumocystis Jiroveci
Pneumonia
Polyarteritis Nodosa Patient
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Journal of Cardio-Thoracic Medicine
Volume 8, Issue 3
Summer 2020
Pages 675-678