Disseminated cytomegalovirus infection in a newly diagnosed HIV-positivepatient: A Case Report

Introduction: Cytomegalovirus (CMV) remains latent in about half of adults and may reactivate in immunocompromised individuals.In advanced HIV infection, CMV can cause systemic disease with end-organ involvement.Case Presentation: A 34-year-old woman with newly diagnosed HIV who had recently started antiretroviral therapy (ART) was referred to our clinic after five days of fever, cough, diarrhea, and ulcerative skin lesions unresponsive to antibiotics.She was hypoxemic and cachectic, with bilateral infiltrates on chest radiography.CMV IgG was positive, IgM was negative, and CMV DNA was detected at 1100 IU/mL.Skin biopsy showed plasma cell-rich dermal inflammation, consistent with disseminated CMV infection involving the lungs, colon, and skin.Intravenous ganciclovir, combined with ongoing ART, led to rapid improvement.After three months, CMV DNA and HIV RNA were undetectable; symptoms had resolved.Conclusion: Disseminated CMV infection should be suspected in newly diagnosed HIV patients during early ART who present with unexplained fever and refractory mucocutaneous lesions.