Advertisement

Journal of Thrombosis and Thrombolysis

, Volume 47, Issue 1, pp 162–164 | Cite as

Acute cytomegalovirus infection associated with pulmonary embolism treated successfully with rivaroxaban: case report

  • Clarissa Maria Gomes de Almeida
  • Fauze Camargo Maluf
  • Feres Camargo Maluf
  • Nelson GaburoJr
  • Ana Flávia Saraceni
  • Cesar de Almeida-NetoEmail author
Article
  • 115 Downloads

Abstract

Severe life-threatening thromboembolism may be caused exclusively by the presence of an acute CMV infection or due to the association of this agent and other thrombogenic factors. We report a case of an immunocompetent young female patient who presented a pulmonary embolism associated with acute CMV infection. The patient did not have any other apparent cause of thrombosis. She was successfully treated with rivaroxaban for 6 months without further episodes. To the best of our knowledge, this is the first report of a pulmonary embolism associated with CMV treated with a direct oral anticoagulant. The current case report calls attention to the importance of signs and symptoms of thromboembolism among patients with CMV. Direct oral anticoagulants can potentially bring the same benefits to treat pulmonary embolism associated with CMV as those observed in patients not infected.

Keywords

Cytomegalovirus Thromboembolism Rivaroxaban Brazil 

Notes

Acknowledgements

We would like to thank Dr. Ricardo Sobhie Diaz, associate professor of the Discipline of Infectious Diseases, Escola Paulista de Medicina, Universidade Federal de São Paulo and Dr. Willi McFarland, associate professor of the Department of Epidemiology and Biostatistics, University of California, San Francisco, for their thoughtful comments and edits.

Funding

No funding was received.

Compliance with ethical standards

Conflict of interest

The authors have no potential conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from the individual participant of the study.

References

  1. 1.
    Keikar AH, Jacob KS, Yousif EB, Farrel JJ (2017) Venous thromboembolism related to cytomegalovirus infection. A case report and literature review. Medicine 96:e9336.  https://doi.org/10.1097/MD.0000000000009336.CrossRefGoogle Scholar
  2. 2.
    Cecarelli M, Rullo EV, Nunnari G (2018) Risk factors of venous thrombo-embolism during cytomegalovirus infection in immunocompetent individuals. Eur J Clin Microbiol Infect Dis 37:381–390.  https://doi.org/10.1007/s10096-018-3185-y CrossRefGoogle Scholar
  3. 3.
    Justo D, Finn T, Atzmony L, Guy N, Steinvil A (2011) Thrombosis associated with acute cytomegalovirus infection: a meta-analysis. Eur J Intern Med 22:195–199.  https://doi.org/10.1016/j.ejim.2010.11.006 CrossRefGoogle Scholar
  4. 4.
    Aztmony L, Halutz O, Avidor B, Finn T, Zimmerman O, Steinveiil A et al (2010) Incidence of cytomegalovirus-associated thrombosis and its risk factors: a case–control study. Thromb Res 126:e439–e443.  https://doi.org/10.1016/j.thromres.2010.09.006 CrossRefGoogle Scholar
  5. 5.
    Rinaldi F, Lissandrin R, Mojoli F, Baldanti F, Brunetti E, Pascarella M, Giordani MT (2014) Acute cytomegalovirus infection as a cause of venous thromboembolism. Mediterr J Hematol Infect Dis 6(1):e2014041.  https://doi.org/10.4084/MJHID.2014.041 CrossRefGoogle Scholar
  6. 6.
    Galli L, Gerdes VEA, Guasti L, Squizzato A (2014) Thrombosis associated with viral hepatitis. J Clin Transl Hepatol 2(4):234–239.  https://doi.org/10.14218/JCTH.2014.00031 Google Scholar
  7. 7.
    Squizzato A, Gerdes VE, Büller HR (2005) Effects of human cytomegalovirus infection on the coagulation system. Thromb Haemost 93:403–410.  https://doi.org/10.1160/TH04-08-0523 CrossRefGoogle Scholar
  8. 8.
    Abgueguen P, Delbos V, Chennebault JM, Payan C, Pichard E (2003) Vascular thrombosis and acute cytomegalovirus infection in immunocompetent patients: report of 2 cases and literature review. Clin Infect Dis 36:e134–e139.  https://doi.org/10.1086/374664 CrossRefGoogle Scholar
  9. 9.
    Schambeck CM, Hinney K, Gleixner J, Keller F (2000) Venous thromboembolism and associated high plasma factor VIII levels: linked to cytomegalovirus infection? Thromb Haemost 83:510–511CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Faculdade de Medicina do ABCSanto AndréBrazil
  2. 2.Unidade de Diagnóstico MolecularDiagnóstico do BrasilSão PauloBrazil
  3. 3.Complexo Hospitalar Professor Edmundo VasconcelosSão PauloBrazil
  4. 4.Disciplina de Ciências MédicasFaculdade de Medicina da Universidade de São PauloSão PauloBrazil

Personalised recommendations