Asymptomatic superior mesenteric vein thrombosis as unusual complication of acute cytomegalovirus infection: a case report

  • Michele Bertoni | micbertoni@libero.it 2nd Unit of Internal Medicine, Santo Stefano New Hospital of Prato, Prato, Italy.
  • Filippo Risaliti 2nd Unit of Internal Medicine, Santo Stefano New Hospital of Prato, Prato, Italy.
  • Alessandra Giani 2nd Unit of Internal Medicine, Santo Stefano New Hospital of Prato, Prato, Italy.
  • Emanuele Calabrese 2nd Unit of Internal Medicine, Santo Stefano New Hospital of Prato, Prato, Italy.
  • Massimo Edoardo Di Natale 2nd Unit of Internal Medicine, Santo Stefano New Hospital of Prato, Prato, Italy.

Abstract

We describe a 39-year-old male who presented with a fever of unknown origin, the diagnostic work-up of which disclosed an acute cytomegalovirus (CMV) infection complicated by a partial superior mesenteric vein (SMV) thrombosis. Further investigations revealed the presence of factor V Leiden mutation. Oral anticoagulant treatment with warfarin led to a complete recanalization of SMV two months after. A literature review on the association between CMV infection and portal system (PS) thrombosis in immunocompetent patients was performed. We found that, in agreement with our case, in a minority of case reports patients did not complain of abdominal pain, but presented with a mononucleosis-like syndrome with malaise and prolonged fever and displayed a variable elevation of aminotransferase levels. Interestingly, most of them exhibited a limited extension of portal thrombosis. On the whole, these data suggest that PS thrombosis during acute CMV infection may be an underestimated complication.

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Published
2015-10-05
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Section
Case Reports
Keywords:
Cytomegalovirus infection, superior mesenteric vein thrombosis, pro-thrombotic risk factors.
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How to Cite
Bertoni, M., Risaliti, F., Giani, A., Calabrese, E., & Di Natale, M. E. (2015). Asymptomatic superior mesenteric vein thrombosis as unusual complication of acute cytomegalovirus infection: a case report. Italian Journal of Medicine, 10(2), 147-150. https://doi.org/10.4081/itjm.2015.596