Fatal Cytomegalovirus Disease in a Previously Healthy Adult

A woman, aged 43, developed symptoms of congestive heart failure apparently due to myocarditis. Signs of encephalitis, subacute hepatitis and adrenal insufficiency were noted during the disease. There was a 4-fold rise in complement-fixing antibodies to cytomegalovirus (CMV) and large intranuclear inclusion-bearing cells were found in the urine. The patient died after 7 months. At autopsy were found changes apparently due to CMV myocarditis and a possibly specific inflammation of the adrenals. The liver showed subacute hepatitis, while no specific changes were seen in the brain or in other organs.