CYTOMEGALOVIRUS APPENDICITIS IN A LIVER-TRANSPLANT RECIPIENT

Cytomegalovirus has been documented as one of the most significant causes of morbidity and mortality following organ transplantation, and colonic involvement has become an increasingly well recognized problem. Appendicitis, however, has been uncommonly reported among these patients. A 37-year-old male developed fever with associated right-sided rebound abdominal tenderness approximately 2 months following orthotopic liver transplantation. He underwent operation where an inflamed appendix was identified. The histologic examination of the removed specimen revealed perivascular foci of inflammation, largely lymphocytic, in association with cells containing pathognomonic nuclear and cytoplasmic CMV inclusions. This patient suffering CMV appendicitis represents the first documented incident among solid organ transplant recipients, and 1 of only 6 patients identified in the literature. Although an uncommon disease entity, CMV appendicitis should be considered a component of the differential diagnosis among organ transplant recipients with abdominal complaints.