Acalculous Cholecystitis: An Unusual Manifestation of Cytomegalovirus Disease in Renal Transplant Recipient

Background: Common clinical manifestations of cytomegalovirus (CMV) infection include flu-like symptoms with fever, diarrhea, leukopenia, and elevated liver enzymes. Diagnosis is made by detection of the virus by buffy-coat blood culture or by polymerase chain reaction (PCR) analysis. Methods: Here we describe a women renal transplant recipient who presented with acalculous cholecystitis with CMV viremia, anemia and leucopenia tree months after she received a kidney from cadaveric donor. Results: Retrospective analysis of peripheral blood by PCR analysis was positive for CMV DNA. Treatement with Intravenous Ganciclovir was started after diagnosis. The role of cholecystectomy in patients diagnosed as having acalculous cholecystitis associated with systemic CMV disease remains unclear. Conclusions: Because CMV infection is common in transplant patients, the atypical manifestations of CMV should be considered in the differential diagnosis of posttransplant complications. Detection of CMV DNA in the peripheral blood by PCR analysis may help identify these patients.