Who’s the Opportunist? CMV Pneumonia in HIV-Infection-Case Report

Abstract

Cytomegalovirus (CMV) pneumonia is a viral infection of the lungs that affects immunocompromised patients. Although it is a rare opportunistic infection in the setting of HIV (Human Immunodeficiency Virus)-infection, in most of these patients, CMV pneumonia is believed to be caused by reactivation secondary to severe immunocompromise. In this article we present a case of a patient with poor immunological status that developed clinical features of respiratory infection. Initially pulmonary pneumocystis was diagnosed and treated accordingly. After presenting clinical worsening, other diagnostic hypotheses were placed and broadspectrum antibiotics and antifungal drugs were administered. However, with no clinical improvement. Facing this, a rarer opportunistic infection, cytomegalovirus (CMV) pneumonia, was considered. The diagnosis of this pathology can be difficult because of its unspecific clinical presentation and radiological findings, however it can be done by detection of positive CMV serostatus together with detection of virus DNA in blood and/ or bronchoalveolar lavage samples. The treatment goal is to stop viral replication, and the first-line therapy is Ganciclovir intravenous (IV).When presenting clinical signs of infection, in HIV positive patients, immunological status should be taken into consideration, and opportunistic infections cannot be overlooked. Early diagnosis allows prompt treatment and potentially complete recovery.