Cytomegalovirus Disease During Severe Drug Eruptions
2009; American Medical Association; Volume: 145; Issue: 9 Linguagem: Inglês
10.1001/archdermatol.2009.195
ISSN1538-3652
AutoresYusuke Asano, Hiroaki Kagawa, Yoko Kano, Tetsuo Shiohara,
Tópico(s)Immunodeficiency and Autoimmune Disorders
ResumoBackground: Overt cytomegalovirus (CMV) disease is a serious viral infection that usually occurs in immunocompromised patients but rarely in immunocompetent patients.Cutaneous lesions, albeit rare, occur as late systemic manifestations of CMV infections and are usually fatal.Observations: We describe 2 patients with druginduced hypersensitivity syndrome (one end of a spectrum of severe drug eruptions) who subsequently developed cutaneous CMV ulcers at unusual sites, such as the trunk; this occurrence was immediately followed by gastrointestinal manifestations, which were fatal in 1 patient.To identify factors predictive of CMV disease, we retrospectively investigated the prevalence of CMV reactivation during drug-induced hypersensitivity syndrome in 18 patients.In this analysis, patients were divided into 2 groups depending on the positivity of CMV DNA in the blood.Conclusions: Older and male patients with antecedent high human herpesvirus 6 DNA loads are at risk for CMV disease irrespective of corticosteroid administration.A rapid reduction in white blood cell numbers is also predictive of the onset of CMV disease.
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