Renal Artery Stenosis Secondary to Cytomegalovirus Infection in an Infant

BACKGROUND: Renal artery stenosis is an uncommon cause of secondary hypertension in infants and is rarely related to infectious etiologies such as cytomegalovirus (CMV). CASE SUMMARY: We report a 5-month-old infant who was admitted for afebrile status epilepticus and found to have severe hypertension. Imaging revealed focal stenosis of the right renal artery. Virological investigations confirmed active CMV infection. The patient was treated with intravenous ganciclovir, leading to normalization of blood pressure and complete radiological resolution of the stenosis within 6 weeks. DISCUSSION: CMV has a known endothelial tropism and may induce inflammatory vascular lesions. Renal artery involvement outside the transplant setting is exceptionally rare. This case highlights a reversible inflammatory vasculopathy related to CMV infection. TAKE-HOME MESSAGES: CMV infection should be considered in infants presenting with unexplained renal artery stenosis. Early antiviral therapy may lead to complete reversibility without invasive intervention.