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Cho, Choi, and Park: A Case of Diffuse Alveolar Hemorrhage Associated with Cytomegalovirus Pneumonia
Case Report
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2008; 64(4): 309-313.

Published online: 30 April 2008

DOI: https://doi.org/10.4046/trd.2008.64.4.309

A Case of Diffuse Alveolar Hemorrhage Associated with Cytomegalovirus Pneumonia

Yong Duck Cho, M.D.1, Hye Sook Choi, M.D.2, Myung Jae Park, M.D.1

1Department of Pulmonary, Allergy and Critical Care Medicine, Kyung Hee University School of Medicine, Seoul, Korea.

2Department of Pulmonary and Critical Care Medicine, Dongguk University College of Medicine, Gyeongju, Korea.

Address for correspondence: Myung Jae Park, M.D. Department of Pulmonary, Allergy and Critical Care Medicine, Kyung Hee University School of Medicine, 1, Hoegi-dong, Dongdaemun-gu, Seoul 130-702, Korea. Phone: 82-2-958-8197, Fax: 82-2-968-1848, mjpwis@chol.com

Received 12 March 2008       Accepted 31 March 2008

Copyright © 2008 The Korean Academy of Tuberculosis and Respiratory Diseases

Abstract

Cytomegalovirus (CMV) pneumonia is a serious opportunistic infection in an immunocompromised host such as an AIDS patient or transplant recipient undergoing immunosuppressive therapy. Diffuse alveolar hemorrhage (DAH) is a relatively uncommon condition and it occurs most often in patients with systemic autoimmune disease. However, various types of infectious pneumonia with Mycoplsma hominis, Stenotrophomonas maltophilia and Pneumocystis jirovecii have been reported to be associated with the development of DAH. The association of CMV infection with the development of DAH has rarely been reported. We experienced a case of DAH associated CMV pneumonia and the patient was successfully treated with the use of antiviral agents and steroids.

Keywords: Cytomegalovirus infections, Diffuse alveolar hemorrhage

Figures and Tables

Figure 1
The Result of CMV-PCR.
1: molecular marker; 2: positive control; 3~5: negative control; 6: patient blood sample; 7: patient BAL sample; 8~10: negative control.
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Figure 2
Chest X-ray showed diffuse bilateral alveolar infiltrates in both lung fields.
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Figure 3
HRCT showed bilateral ground glass opacities and interlobular septal thickening in both lung fields and pleural effusion especially in left side.
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Figure 4
Bronchoalveolar lavage fluid showed hemosiderin laden macrophages (Prussian-Blue staining, ×200).
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Figure 5
Chest X-ray showed improvement after the treatment with ganciclovir and steroid.
trd-64-309-g005

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