A Case Treated with Extracorporeal Membrane Oxygenation for Disseminated Cytomegalovirus Infection after Liver Transplantation.
10.4285/jkstn.2017.31.2.75
- Author:
Jimyung PARK
1
;
Yoon Hyun LEE
;
Young Rok CHOI
;
Yeon Joo LEE
;
Dong Jung KIM
;
Sanghoon JHEON
;
Young Jae CHO
Author Information
1. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea. lungdrcho@snubh.org
- Publication Type:Case Report
- Keywords:
Cytomegalovirus;
Extracorporeal membrane oxygenation;
Liver transplantation;
Sepsis
- MeSH:
Cytomegalovirus Infections*;
Cytomegalovirus*;
Diagnosis, Differential;
Extracorporeal Membrane Oxygenation*;
Hepatitis;
Humans;
Immunocompromised Host;
Immunosuppression;
Liver Transplantation*;
Liver*;
Organ Transplantation;
Pneumonia;
Respiratory Insufficiency;
Sepsis;
Transplants
- From:The Journal of the Korean Society for Transplantation
2017;31(2):75-81
- CountryRepublic of Korea
- Language:English
-
Abstract:
Cytomegalovirus (CMV) is a clinically important pathogen in immunocompromised patients, especially after organ transplantation. However, there have been several reports of severe CMV infections in immunocompetent patients. This report presents a case of an immunocompetent patient who presented with fulminant hepatitis requiring liver transplantation. Because CMV was detected upon histopathologic review of the explanted liver, it was later assumed that CMV may be the primary cause of hepatitis. However, at the time of transplantation, we did not suspect CMV hepatitis. Following transplantation and initiation of immunosuppression, the patient developed viral sepsis with a disseminated CMV infection. Respiratory failure because of CMV pneumonia worsened despite antiviral therapy, and venovenous extracorporeal membrane oxygenation (ECMO) was initiated. Although ECMO has been traditionally contraindicated in patients with sepsis, this patient recovered and was successfully weaned off ECMO. CMV should be included in the differential diagnosis of fulminant hepatitis, even in immunocompetent patients, especially when liver transplantation is considered.
