Cytomegalovirus esophagitis associated with arytenoid cyst in an immunocompetent host
DOI:
https://doi.org/10.18203/issn.2454-5929.ijohns20233586Keywords:
Cytomegalovirus, Esophagitis, Ganciclovir, Arytenoid, Immunocompetent, CystAbstract
CMV esophagitis is usually encountered in immunocompromised individuals and esophagus is rarely affected in immunocompetent individuals. CMV esophagitis associated with arytenoid cyst has not yet been reported in literature to the best of my knowledge and can be considered in case of recurrence of cyst following excision. The objective of this study is to report the unique presentation of CMV in an immunocompetent patient. A middle-aged immunocompetent lady presenting with dysphagia was diagnosed to have arytenoid cyst. Biopsy from upper esophagus revealed cytomegalovirus inclusion bodies and immunological test were performed to confirm the pathology. The cyst excision lead to recurrence. It was excised again followed by a course of intravenous ganciclovir. Currently, the role of antiviral in treatment of CMV esophagitis in immunocompetent individual is not well established. We have obtained good result in this patient with a course of Ganciclovir following excision of the cyst. The rarity of cytomegaloviral upper esophageal involvement, its association with arytenoid cyst and the utility of antivirus in treatment of an immunocompetent host makes this case report unique and interesting.
References
Klauber E, Briski LE, Khatib R. Cytomegalovirus colitis in the immunocompetent host: An overview. Scand J Infect Dis. 1998;30:559-64.
Yagain K, Rao L, Pai K, Pai G. Cytomegalovirus oesophagitis in nonimmunocompromised patient- presenting as an acute necrotic (black) oesophagitis. Indian J Pathol Microbiol. 2011;54:852-3.
Goodgame RW. Gastrointestinal cytomegalovirus disease. Ann Intern Med. 1993;119:924-35.
Wreghitt TG, Teare EL, Sule O, Devi R, Rice P. Cytomegalovirus infection in immunocompetent patients. Clin Infect Dis. 2003;37:1603-6.
Lim DS, Lee TH, Jin SY, Lee JS. Cytomegalovirus esophagitis in an immunocompetent patient: Case report. Turk J Gastroenterol. 2014;25:571-4.
Wilcox CM, DL Diehl, Cello JP, Margaretten W, Jacobson MA. Cytomegalovirus esophagitis in patients with AIDS. A clinical, endoscopic and pathologic correlation. Ann Intern Med. 1990;113:58993.
Limaye AP, Kirby KA, Rubenfeld GD, Leisenring WM, Bulger EM, Neff MJ, Gibran NS, Haung ML, Santo TK, Corey L. Cytomegalovirus reactivation in critically ill immunocompetent patients. JAMA. 2008;300:413-22.
Levine PA, Marelli RA, Biddinger PW, Gluckman JL. Cytomegalovirus infection of the larynx in the acquired immunodeficiency syndrome. Otolaryngol Head Neck Surg. 19992;106(3):296-301.
Weile J, Streeck B, Muck J, Krebs G, Jakobus KH, Knabbe C, Weber F. Severe cytomegalovirus-associated esophagitis in an immunocompetent patient after short-term steroid therapy. J Clin Microbiol. 2009;47:3031-3.
Whitley RJ, Jacobson MA, Friedberg DN, Holland GN, Jabs DA, Dieterich DT et al. Guidelines for the treatment of cytomegalovirus diseases in patients with AIDS in the era of potent antiretroviral therapy: recommendations of an international panel. International AIDS Society- USA. Arch Intern Med. 1998;158(9):957-69.
