Ioannis Bountouris1, Demetrios Moris2, Diamantis I Tsilimigras3, George Laoutaris4, Georgia Kritikou1, Viktoria-Varvara Palla5, Georgios Karaolanis6. 1. Department of Vascular Surgery, 251 General Hospital of Hellenic Air Force, Athens, Greece. 2. Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center, Columbus, OH, U.S.A. 3. 1st Department of Surgery, Vascular Surgery Unit, Laikon General Hospital, Medical School of Athens, Athens, Greece. 4. 1st Department of Internal Medicine, 251 General Hospital of Hellenic Air Force, Athens, Greece. 5. Department of Obstetrics and Gynecology, Alexandra General Hospital, Athens, Greece. 6. 1st Department of Surgery, Vascular Surgery Unit, Laikon General Hospital, Medical School of Athens, Athens, Greece drgikaraolanis@gmail.com.
Abstract
BACKGROUND/AIM: Cytomegalovirus (CMV) infection is a common disease especially in young adults. Thromboembolism like deep vein thrombosis and pulmonary embolism is increased among patients with CMV infection. Most cases represent immunocompromised patients usually treated with low molecular weight heparin. CASE REPORT: Herein, we describe a 25-year-old immunocompetent male who presented at the emergency department with sudden onset of chest pain. One month prior to admission, he had developed persistent fever and cough and the diagnosis of CMV infection had been established. After extensive workup, the diagnosis of pulmonary embolism after CMV infection was set and he was treated with rivaroxaban. During the next six months the patient continued on the same anticoagulant therapy with no other episode of pulmonary embolism at 1-year follow-up. CONCLUSION: To our knowledge, this is the first case of CMV-associated pulmonary embolism treated with novel oral anticoagulants (NOACs). NOACs, such as rivaroxaban, seem to be safe and may represent an attractive alternative with promising results in this particular group of patients. Studies incorporating a greater cohort of patients are needed in order to draw safe conclusions regarding the relationship between NOACs and CMV infection. Copyright
BACKGROUND/AIM: Cytomegalovirus (CMV) infection is a common disease especially in young adults. Thromboembolism like deep vein thrombosis and pulmonary embolism is increased among patients with CMV infection. Most cases represent immunocompromised patients usually treated with low molecular weight heparin. CASE REPORT: Herein, we describe a 25-year-old immunocompetent male who presented at the emergency department with sudden onset of chest pain. One month prior to admission, he had developed persistent fever and cough and the diagnosis of CMV infection had been established. After extensive workup, the diagnosis of pulmonary embolism after CMV infection was set and he was treated with rivaroxaban. During the next six months the patient continued on the same anticoagulant therapy with no other episode of pulmonary embolism at 1-year follow-up. CONCLUSION: To our knowledge, this is the first case of CMV-associated pulmonary embolism treated with novel oral anticoagulants (NOACs). NOACs, such as rivaroxaban, seem to be safe and may represent an attractive alternative with promising results in this particular group of patients. Studies incorporating a greater cohort of patients are needed in order to draw safe conclusions regarding the relationship between NOACs and CMV infection. Copyright
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