CMV Infection in Adult-Onset Disease: An unusual presentation

摘要

Adult-onset-still's disease is systemic inflammatory disorder of unknown origin, several reports have suggested a triggering infection in Adult-onset- still's disease, we describe a case of uncommon presentation of ASD associated with cytomegalovirus infection. A 25 year-old male was admitted to our hospital complaining of high fever. The physical examination showed Right basal crepitation, with pericardial rub. Although several antibiotics were administered, the spiking high fever was not alleviated. Two weeks after admission a macular rash appeared, and a high concentration of serum ferritin was observed. At this point, Still's disease was suspected. During the prescribed course of prednisolone, hepatic enzymes gradually increased accompanied by a positive test for cytomegalovirus (CMV) antigen. The symptoms disappeared after administration of gancyclovir and steroid. In this report, we attempt to portray the relation between the pathogenesis of adultonset Still's disease and the presence of CMV antigen.