Pulmonary Embolism in a Young Immunocompetent Adult Infected with Cytomegalovirus. Are Novel Oral Anticoagulants an Efficient Alternative?

Journal Article (Journal Article)


Cytomegalovirus (CMV) infection is a common disease especially in young adults. Thromboembolism like deep vein thrombosis and pulmonary embolism is increased among patients with CMV infection. Most cases represent immunocompromised patients usually treated with low molecular weight heparin.

Case report

Herein, we describe a 25-year-old immunocompetent male who presented at the emergency department with sudden onset of chest pain. One month prior to admission, he had developed persistent fever and cough and the diagnosis of CMV infection had been established. After extensive workup, the diagnosis of pulmonary embolism after CMV infection was set and he was treated with rivaroxaban. During the next six months the patient continued on the same anticoagulant therapy with no other episode of pulmonary embolism at 1-year follow-up.


To our knowledge, this is the first case of CMV-associated pulmonary embolism treated with novel oral anticoagulants (NOACs). NOACs, such as rivaroxaban, seem to be safe and may represent an attractive alternative with promising results in this particular group of patients. Studies incorporating a greater cohort of patients are needed in order to draw safe conclusions regarding the relationship between NOACs and CMV infection.

Full Text

Duke Authors

Cited Authors

  • Bountouris, I; Moris, D; Tsilimigras, DI; Laoutaris, G; Kritikou, G; Palla, V-V; Karaolanis, G

Published Date

  • November 2017

Published In

Volume / Issue

  • 31 / 6

Start / End Page

  • 1193 - 1195

PubMed ID

  • 29102945

Pubmed Central ID

  • PMC5756651

Electronic International Standard Serial Number (EISSN)

  • 1791-7549

International Standard Serial Number (ISSN)

  • 0258-851X

Digital Object Identifier (DOI)

  • 10.21873/invivo.11189


  • eng