Rinsho Shinkeigaku (Clinical Neurology)

Case Report

Cytomegalovirus associated myelitis in a non-immunocompromised adult due to initial cytomegalovirus infection

Nobuhiro Ido, M.D.1), Hirohisa Kato, Ph.D.1), Yuki Akiba, M.D.1), Tomoko Saito, M.D.1), Eri Watanabe, M.D.1) and Hitoshi Aizawa, Ph.D.1)

1) Department of Neurology, Tokyo Medical University Hospital

The patient was a 30-year-old man who developed muscle weakness in both lower extremities, sensory deficits below the fourth thoracic spinal cord level, and bladder rectal dysfunction owing to cytomegalovirus (CMV) associated myelitis. His blood tests showed mononucleosis, hepatic dysfunction, and the presence of serum CMV-IgM antibodies, and T2-weighted imaging on MRI displayed a continuous high signal on the ventral side of the spinal cord. Although his medical history and laboratory tests did not indicate that he was immunocompromised, we speculated he had CMVassociated myelitis. As the first infection with CMV in a non-immunocompromised adult can result in mononucleosis, we considered that this patient developed myelitis after mononucleosis caused by CMV infection for the first time. CMVassociated myelitis in non-immunocompromised individuals is rare. In general, CMV infections are common in immunosuppressed individuals. However, in Japan, adults with CMV antibodies have recently been decreasing, and hence CMV infections in non-immunocompromised adults are expected to increase in the future.
Full Text of this Article in PDF (1824K)

(CLINICA NEUROL, 62: 922|927, 2022)
key words: cytomegalovirus, initial infection, non-immunocompromised, cytomegalovirus mononucleosis, myelitis

(Received: 19-May-22)