CMV Retinitis in the Context of SARS-CoV-2 Infection: A Case Study and Comprehensive Review of Viral Interactions

Purpose: Cytomegalovirus (CMV) retinitis is a sight-threatening condition predominantly affecting immunocompromised individuals, such as those with Human Immunodeficiency Virus (HIV)/Acquired Immunodeficiency Syndrome (AIDS). We aimed to present an observational case report on CMV retinitis followin...

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Main Authors: Emil Robert Stoicescu, Laura Andreea Ghenciu, Roxana Iacob, Adina Iuliana Ardelean, Ecaterina Dăescu, Ovidiu Alin Hațegan, Diana Manolescu, Emanuela Tudorache, Casiana Boru, Mirabela Dima
Format: Article
Language:English
Published: MDPI AG 2024-10-01
Series:Pathogens
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Online Access:https://www.mdpi.com/2076-0817/13/11/938
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author Emil Robert Stoicescu
Laura Andreea Ghenciu
Roxana Iacob
Adina Iuliana Ardelean
Ecaterina Dăescu
Ovidiu Alin Hațegan
Diana Manolescu
Emanuela Tudorache
Casiana Boru
Mirabela Dima
author_facet Emil Robert Stoicescu
Laura Andreea Ghenciu
Roxana Iacob
Adina Iuliana Ardelean
Ecaterina Dăescu
Ovidiu Alin Hațegan
Diana Manolescu
Emanuela Tudorache
Casiana Boru
Mirabela Dima
author_sort Emil Robert Stoicescu
collection DOAJ
description Purpose: Cytomegalovirus (CMV) retinitis is a sight-threatening condition predominantly affecting immunocompromised individuals, such as those with Human Immunodeficiency Virus (HIV)/Acquired Immunodeficiency Syndrome (AIDS). We aimed to present an observational case report on CMV retinitis following Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection and to review the literature on the molecular and cellular changes in CMV and SARS-CoV-2 infections and how they may influence each other. <b>Case Description:</b> A 32-year-old man with a history of AIDS presented with decreased vision and ocular pain exacerbated by movement, beginning a day prior. Ocular examination revealed anterior uveitis, corneal endothelial edema, and retinal necrosis in the left eye. CMV retinitis was diagnosed based on positive serologic testing and a low cluster of differentiation 4 (CD4) count, with concurrent SARS-CoV-2 infection detected. Treatment included valganciclovir and topical agents, with a focus on managing CMV complications. This case highlights the potential role of SARS-CoV-2 in reactivating dormant CMV in severely immunocompromised individuals. We also discuss the implications of this interaction for immunocompromised patients, emphasizing the need for vigilant monitoring and personalized treatment strategies. <b>Conclusions:</b> Our case suggests that SARS-CoV-2 may trigger reactivation of CMV infection, leading to bilateral involvement in patients with low CD4 lymphocyte counts, which can result in severe visual impairment. The review discusses the molecular and cellular interactions between CMV and SARS-CoV-2, as well as risk factors, pathophysiology, and diagnostic methods for CMV retinitis, providing recommendations based on the literature findings.
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spelling doaj-art-fa32dea60fd74f6894ec3c3377de03d22024-11-26T18:16:43ZengMDPI AGPathogens2076-08172024-10-01131193810.3390/pathogens13110938CMV Retinitis in the Context of SARS-CoV-2 Infection: A Case Study and Comprehensive Review of Viral InteractionsEmil Robert Stoicescu0Laura Andreea Ghenciu1Roxana Iacob2Adina Iuliana Ardelean3Ecaterina Dăescu4Ovidiu Alin Hațegan5Diana Manolescu6Emanuela Tudorache7Casiana Boru8Mirabela Dima9Radiology and Medical Imaging University Clinic, ‘Victor Babes’ University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, RomaniaDepartment of Functional Sciences, ‘Victor Babes’ University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, RomaniaResearch Center for Medical Communication, ‘Victor Babes’ University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, RomaniaDiscipline of Ophtalmology, ‘Victor Babes’ University of Medicine and Pharmacy Timisoara, 300041 Timisoara, RomaniaDepartment of Anatomy and Embriology, ‘Victor Babes’ University of Medicine and Pharmacy Timisoara, 300041 Timisoara, RomaniaDiscipline of Anatomy and Embriology, Medicine Faculty, “Vasile Goldis” Western University of Arad, Revolution Boulevard 94, 310025 Arad, RomaniaRadiology and Medical Imaging University Clinic, ‘Victor Babes’ University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, RomaniaCenter for Research and Innovation in Precision Medicine of Respiratory Diseases (CRIPMRD), ‘Victor Babes’ University of Medicine and Pharmacy Timisoara, 300041 Timisoara, RomaniaDiscipline of Anatomy and Embriology, Medicine Faculty, “Vasile Goldis” Western University of Arad, Revolution Boulevard 94, 310025 Arad, RomaniaDepartment of Neonatology, ‘Victor Babes’ University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, RomaniaPurpose: Cytomegalovirus (CMV) retinitis is a sight-threatening condition predominantly affecting immunocompromised individuals, such as those with Human Immunodeficiency Virus (HIV)/Acquired Immunodeficiency Syndrome (AIDS). We aimed to present an observational case report on CMV retinitis following Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection and to review the literature on the molecular and cellular changes in CMV and SARS-CoV-2 infections and how they may influence each other. <b>Case Description:</b> A 32-year-old man with a history of AIDS presented with decreased vision and ocular pain exacerbated by movement, beginning a day prior. Ocular examination revealed anterior uveitis, corneal endothelial edema, and retinal necrosis in the left eye. CMV retinitis was diagnosed based on positive serologic testing and a low cluster of differentiation 4 (CD4) count, with concurrent SARS-CoV-2 infection detected. Treatment included valganciclovir and topical agents, with a focus on managing CMV complications. This case highlights the potential role of SARS-CoV-2 in reactivating dormant CMV in severely immunocompromised individuals. We also discuss the implications of this interaction for immunocompromised patients, emphasizing the need for vigilant monitoring and personalized treatment strategies. <b>Conclusions:</b> Our case suggests that SARS-CoV-2 may trigger reactivation of CMV infection, leading to bilateral involvement in patients with low CD4 lymphocyte counts, which can result in severe visual impairment. The review discusses the molecular and cellular interactions between CMV and SARS-CoV-2, as well as risk factors, pathophysiology, and diagnostic methods for CMV retinitis, providing recommendations based on the literature findings.https://www.mdpi.com/2076-0817/13/11/938CMV retinitisSARS-CoV-2CMV interactionCOVID-19cytomegalovirusAIDS-related CMV retinitis
spellingShingle Emil Robert Stoicescu
Laura Andreea Ghenciu
Roxana Iacob
Adina Iuliana Ardelean
Ecaterina Dăescu
Ovidiu Alin Hațegan
Diana Manolescu
Emanuela Tudorache
Casiana Boru
Mirabela Dima
CMV Retinitis in the Context of SARS-CoV-2 Infection: A Case Study and Comprehensive Review of Viral Interactions
Pathogens
CMV retinitis
SARS-CoV-2
CMV interaction
COVID-19
cytomegalovirus
AIDS-related CMV retinitis
title CMV Retinitis in the Context of SARS-CoV-2 Infection: A Case Study and Comprehensive Review of Viral Interactions
title_full CMV Retinitis in the Context of SARS-CoV-2 Infection: A Case Study and Comprehensive Review of Viral Interactions
title_fullStr CMV Retinitis in the Context of SARS-CoV-2 Infection: A Case Study and Comprehensive Review of Viral Interactions
title_full_unstemmed CMV Retinitis in the Context of SARS-CoV-2 Infection: A Case Study and Comprehensive Review of Viral Interactions
title_short CMV Retinitis in the Context of SARS-CoV-2 Infection: A Case Study and Comprehensive Review of Viral Interactions
title_sort cmv retinitis in the context of sars cov 2 infection a case study and comprehensive review of viral interactions
topic CMV retinitis
SARS-CoV-2
CMV interaction
COVID-19
cytomegalovirus
AIDS-related CMV retinitis
url https://www.mdpi.com/2076-0817/13/11/938
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