CYTOMEGALOVIRUS MYOCARDITIS FOLLOWING LIVER-TRANSPLANTATION

Cytomegalovirus (CMV) infections are commonly found in patients on imm unosuppressive therapy following liver transplantation. However, acute myocarditis is an extremely rare manifestation of CMV infection in th is setting. We report the case of a patient who developed acute myocar ditis with severe biventricular failure with a cardiac ejection fracti on of less than 10%, 6 weeks following orthotopic liver transplantatio n. Systemic CMV infection was diagnosed on the basis of a clinical vir aemia, the presence of CMV antigen in urine, blood, and throat swab, a nd an associated four-fold rise in serum antibody titres to CMV. A ful l recovery ensued following treatment with standard anti-cardiac failu re therapy and a 10 day course of intravenous ganciclovir.