Cytomegalovirus hepatitis and myopericarditis

Cytomegalovirus （CMV） infection in inmunocompetent hosts generally is asymptomatic or may present as a mononucleosis syndrome but rarely can lead to severe organ complications. We report a case of simultaneous hepatic and pericardic CMV infection in a 36-year old immunocompetent man. He was admitted to coronary unit with fever, chest pain radiated to shoulders, changes on electrocardiogram with diffuse ST elevation and modest laboratory elevations in the MB fraction of creatine kinase （CK-MB） of 33.77 μg/L （0.1-6.73）, serum cardiac troponin T of 0.904 ng/mL （0-0.4）, creatine kinase of 454 U/L （20-195） and myoglobin of 480.4 μg/L （28-72）. Routine laboratory test detected an elevation of aminotransferase level： alanine aminotransferase 1445 U/L, aspartate aminotransferase 601 U/L. We ruled out other causes of hepatitis with normal results except IgM CMV. The patient was diagnosed with myopericarditis and hepatitis caused by cytomegalovirus and started symptomatic treatment with salicylic acid. In few days the laboratory findings became normal and the patient was discharged.     

Purulent pericarditis caused by nontypeable Haemophilus influenzae in a pediatric patient

We report the 1st case of purulent pericarditis due to nontypeable Haemophilus influenzae in an immunocompetent 2-year-old male, which was successfully treated with surgical drainage, debridement, and antimicrobial therapy. The shifting microbial epidemiology of this disease, associated with changes in community health care practices, and the increasing virulence of this organism are discussed.