Immune thrombocytopenic purpura (ITP), an autoimmune disorder causing dangerously low platelet counts, is rarely associated with cytomegalovirus (CMV) infection in otherwise healthy individuals. However, a recently published case report, authored by Francisca Nunes Silva, Centro de Saúde de Câmara de Lobos, Funchal, Portugal, and team, underscored the need for vigilance in diagnosing CMV as a potential culprit in unexplained thrombocytopenia.
A 34-year-old male presented with progressively worsening erythematous macules, spontaneous ecchymoses, ulcerative oral lesions, and recurrent nosebleeds. A detailed examination revealed extensive petechiae and multiple violaceous oral lesions. Serologic tests confirmed CMV infection, prompting targeted antiviral therapy.
While CMV infections are commonly observed in immunocompromised patients, this case highlighted its potential to cause severe hematologic complications even in immunocompetent individuals. Challenges in diagnosing CMV-related ITP stem from its low prevalence, nonspecific symptoms, and mimicry of other conditions. Yet, timely identification and treatment are critical.
In cases of severe ITP unresponsive to standard therapies, healthcare professionals are encouraged to consider CMV in the differential diagnosis. Early antiviral intervention can be life-saving and mitigate complications.
This case demonstrated the need for a broad differential when encountering unexplained thrombocytopenia, particularly in otherwise healthy adults. CMV’s subtle but significant impact on hematologic health demands awareness and proactive management.
Reference: Nunes Silva F et al. Immune Thrombocytopenic Purpura Secondary to Cytomegalovirus (CMV) Infection: A Clinical Case. Cureus. 2024;16(12):e75334.
Anaya Malik | AMJ
