case_images: PMC5671693_01
case_images: PMC5671693_02
case_images: Levels of cytomegalovirus DNA by polymerase chain reaction recorded from time of identification of viral reactivation demonstrating a paraclinical response to antiviral medication.
case_images: CRIHEM2017-5762525.001.jpg
case_images: PMC5671693_02_CRIHEM2017-5762525.001.jpg
case_images: fig1
case_images: Extensive investigations including a full viral screen with polymerase chain reaction (PCR) for CMV showed a CMV viral load of 3,328,814 copies/ml (ref. <180 copies/ml) (Figure 1()), and treatment was commenced with ganciclovir 5 mg/kg for CMV colitis. ALT to 117 U/l (ref. 10-50 U/l), alkaline phosphatase 815 U/l (ref. 40-130 U/l), and gamma glutamyl transferase 1550 U/l (ref. 10-70 U/l). At this time, the CMV viral load had decreased to 812,307 copies/ml (Figure 1()).
case_images: PMC5671693_03
case_images: Levels of cytomegalovirus DNA by polymerase chain reaction recorded during patient's second hospital admission demonstrating a subsequent increase in viral load following an initially good response to treatment.
case_images: CRIHEM2017-5762525.002.jpg
case_images: PMC5671693_03_CRIHEM2017-5762525.002.jpg
case_images: fig2
case_images: The CMV viral titre increased during the admission despite ongoing treatment with high-dose valganciclovir and remained detectable for two months following discharge (Figure 2()). However, at the end of the study (14 September 2016), CMV levels had again started to increase (Figure 2()).