Challenges in Diagnosing Post-Splenectomy Cytomegalovirus Mononucleosis

Kim Abbegail Tan Aldecoa; Rahul Pidikiti; Jaisal Brar; Geetha Krishnamoorthy; Shamla Kalyan; Cecilia Cosma; Pritha Chitagi

doi:10.12890/2024_004263

Challenges in Diagnosing Post-Splenectomy Cytomegalovirus Mononucleosis

Eur J Case Rep Intern Med. 2024 Jan 8;11(2):004263. doi: 10.12890/2024_004263. eCollection 2024.

Authors

Kim Abbegail Tan Aldecoa^{1

2}, Rahul Pidikiti^{1

2}, Jaisal Brar^{1

2}, Geetha Krishnamoorthy^{1

2}, Shamla Kalyan³, Cecilia Cosma^{1

2}, Pritha Chitagi^{1

2}

Affiliations

¹ Department of Internal Medicine, Trinity Health Oakland, Pontiac, USA.
² Wayne State University, Detroit, USA.
³ Department of Infectious Diseases, Trinity Health Oakland, Pontiac, USA.

Abstract

Cytomegalovirus (CMV) infection is often asymptomatic. However, in certain individuals, it can cause non-specific signs and symptoms that maybe hard to recognise. The condition may therefore be overlooked or misdiagnosed, leading to prolonged illness and serious sequelae. In this case report, we present a rare instance of CMV infection in an HIV-negative patient who had a remote history of splenectomy and was experiencing prolonged fever and markedly elevated white blood cell (WBC) count.

Learning points: The clinical presentation of CMV infection in a post-splenectomy patient can be intricate and deceptive, involving non-specific symptoms such as prolonged fever and a markedly elevated WBC count.The decision on treatment among individuals without apparent risk factors (such as AIDS, transplant, or cancers) led to in-depth deliberations and discussion.Post-splenectomy patients with CMV infection may exhibit prolonged illness, potentially leading to severe consequences if left untreated.

Keywords: CMV mononucleosis; Cytomegalovirus; post-splenectomy.