Abstract
Fever of unknown origin (FUO) may be due to infection, malignancy, collagen vascular/inflammatory disorders, or other causes. Cytomegalovirus (CMV) infection is a rare cause of FUO in immunocompetent adults. We present a case of FUO due to CMV in an immunocompetent adult with polyclonal gammopathy on serum protein electrophoresis (SPEP).
References
Cunha BA. Fever of unknown origin (FUO). In: Gorbach SL, Bartlett JB, Blacklow NR, editors. Infectious diseases in medicine and surgery. 2nd ed. Philadelphia: Saunders; 1997.
Cunha BA. Fever of unknown origin: clinical overview and perspective. In: Cunha BA, editor. Fever of unknown origin. New York: Informa Healthcare; 2007.
Teglia O, Cunha BA. CMV induced SLE presenting as a fever of unknown origin. Infect Dis Pract. 1993;17:7–8.
Mickail N, Nausheen S, Cunha BA. Fever of unknown origin (FUO): cytomegalovirus (CMV) in an immuno-competent host. Infect Dis Pract. 2007;21:629–30.
Cunha BA, Pherez F, Walls N. Severe cytomegalovirus (CMV) community-acquired pneumonia (CAP) in a nonimmunocompromised host. Heart Lung. 2009;38:243–8.
Cunha BA. Cytomegalovirus pneumonia: community-acquired pneumonia (CAP) in immunocompetent hosts. Infect Dis Clin North Am. 2010;24:147–58.
Cunha BA, Strollo S, Durie N. Cytomegalovirus reactivation in the intensive care unit: not a cause of late-onset ventilator-associated pneumonia. Crit Care Med. 2010;38:341–2.
Cohen JI, Corey GR. Cytomegalovirus infection in the normal host. Medicine (Baltimore). 1985;64:100–14.
Ho M. Cytomegalovirus: biology and infection. 2nd ed. New York: Plenum; 1991.
Pass RF. Cytomegalovirus. In: Knipe DM, Howley PM, editors. Field virology, vol 2. 4th ed. Philadelphia: Lippincott, Williams & Wilkins; 2001. p. 2675–705.
Cunha BA. Fever of unknown origin: clinical overview of classic and current concepts. Infect Dis Clin North Am. 2007;21:867–915.
Cunha BA. Fever of unknown origin: focused diagnostic approach based on clinical clues from the history, physical examination, and laboratory tests. Infect Dis Clin North Am. 2007;21:1137–87.
Cunha BA, Gouzhva O, Nausheen S. Severe cytomegalovirus (CMV) community-acquired pneumonia (CAP) precipitating a systemic lupus erythematosus (SLE) flare. Heart Lung. 2009;38:249–52.
Wallach J. Interpretation of diagnostic tests. 8th ed. Philadelphia: Lippincott, Williams & Wilkins; 2007. p. 480–98.
Cunha CB. Infectious disease differential diagnosis. In: Cunha BA, editor. Antibiotic essentials. 9th ed. Sudbury: Jones & Bartlett; 2010. p. 486–8.
Vodopick H, Chaskes SJ, Solomon A, Stewart JA. Transient monoclonal gammopathy associated with cytomegalovirus infection. Blood. 1974;44:189–95.
Seigneurin JM, Renversez JC, Baccard M, Seigneurin D, Micouin C. Monoclonal cryoimmunoglobulin with anti-cytomegalovirus activity associated with T cell chronic lymphocytic leukaemia. Clin Exp Immunol. 1980;41:317–25.
Haas H, Anders S, Bornkamm GW, Mannweiler E, Schmitz H, Radl J, Schlaak M. Do infections induce monoclonal immunoglobulin components? Clin Exp Immunol. 1990;81:435–40.
Bühler S, Laitinen K, Holthöfer H, Järvinen A, Schauman KO, Hedman K. High rate of monoclonal gammopathy among immunocompetent subjects with primary cytomegalovirus infection. Clin Infect Dis. 2002;35:1430–3.
Park KH, Bang JH, Park WB, Kim HB, Kim NJ, Ahn JK, Chang KH, Oh MD, Choe KW. Retrobulbar optic neuritis and meningoencephalitis following progressive outer retinal necrosis due to CMV in a patient with AIDS. Infection. 2008;36:475–9.
Vetter M, Battegay M, Trendelenburg M. Primary cytomegalovirus infection with accompanying Pneumocystis jiroveci pneumonia in a patient with large-vessel vasculitis. Infection. 2010;38:331–4.
Hong K-W, Kim SI, Kim YJ, Wie SH, Kim YR, Yoo J-H, Han NI, Kang MW. Acute cytomegalovirus pneumonia and hepatitis presenting during acute HIV retroviral syndrome. Infection. 2011;39:155–9.
Conflict of interest
The authors have no conflict of interest and no funding was obtained in the writing of this manuscript.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Cunha, B.A., Hage, J.E. & Nouri, Y. Fever of unknown origin (FUO) in an immunocompetent adult due to cytomegalovirus (CMV) with polyclonal gammopathy. Infection 40, 327–330 (2012). https://doi.org/10.1007/s15010-011-0191-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s15010-011-0191-8